Home > EHR, Medicare > HHS OIG Releases New Report on Use of EHR Technology to Inflate or Duplicate Claims

HHS OIG Releases New Report on Use of EHR Technology to Inflate or Duplicate Claims

The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) released another report today on the intentional or unintentional use of EHR technology to submit claims for services that were not provided.

OIG’s two examples of fraudulent use are “copy-pasting,” which is selecting information from one source and replicating it in another location to inflate and/or duplicate claims; and, “overdocumentation,” which is inserting false or irrelevant documentation to create the appearance of support for billing higher level services. OIG noted that overdocumentation could be unintentionally instigated by auto-populated fields and templates in certain EHR technology.

OIG recommended that the Centers for Medicare and Medicaid Services (CMS) provide more explicit guidance to contractors on detecting EHR-facilitated fraud. OIG also recommended that CMS direct its contractors to use providers’ audit log data when reviewing medical records to confirm that the claims were for rendered services. In its formal response, CMS agreed with the first recommendation and partially agreed with the second, but noted that audit log review may not be appropriate in every circumstance.

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Categories: EHR, Medicare
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