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Don't Overlook Fraud in EHRs, OIG Cautions CMS

Jacqueline Fellows, for HealthLeaders Media, January 9, 2014

The Centers for Medicare & Medicaid Services has eagerly pushed EHRs onto healthcare providers without adequately addressing the risk of fraud, suggests a report from the Office of Inspector General.

Despite the increased focus on fraud and abuse of Medicare and Medicaid, the Office of Inspector General issued a report this month that found contractors for the Centers for Medicare & Medicaid Services need to do more to protect the integrity of electronic health records [PDF].

Among its findings and recommendations, the report notes that health officials have eagerly pushed EHRs without addressing the risk of fraud.

"The Department of Health and Human Services has spent considerable resources to promote widespread adoption of EHRs... It has directed less attention to addressing potential fraud and abuse vulnerabilities in EHRs despite the challenges they pose to the integrity of medical records."

CMS, OIG, the Department of Justice, and other government agencies have invested money and manpower to reduce Medicare and Medicaid fraud and abuse in recent years. In 2010, the Center for Public Integrity was created to align fraud and abuse prevention resources for both the Medicare and Medicaid programs.

Two years later, CMS unveiled a $3.6 million Program Integrity Command Center where investigators, analysts, and policy makers could work together physically in one space. And last year, CMS gave state-run Medicaid Fraud Control Units the power to data mine for fraudulent activity.

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