Huffpost Business

Justice Department Warns Hospitals Not To Game Medicare System

Posted: Updated:
JUSTICE DEPARTMENT WARNS HOSPITALS
AP

WASHINGTON (AP) — Computerized medical records were supposed to cut costs. Now the Obama administration is warning hospitals that might be tempted to use the technology for gaming the system.

Health and Human Services Secretary Kathleen Sebelius (seh-BEEL'-yuhs) and Attorney General Eric Holder issued the warning Monday in a letter to hospital trade associations, following media reports of alleged irregularities.

The letter said there were indications that some providers were using computerized records technology to possibly obtain payments to which they were not entitled. It raised the threat of prosecution.

Among the practices under scrutiny is what's called "upcoding" — or raising the severity of a patient's condition to get more money.

Hospitals say part of the problem is that Medicare has lagged in updating billing guidelines for emergency room and clinic visits.

Around the Web

HHS, Justice Department warn hospitals on EHR-related payment ...

Healthcare business news, research and events from Modern ...

A Giant Hospital Chain Is Blazing a Profit Trail - The New York Times

Healthcare Business News HHS, Justice Department warn hospitals on EHR ...

Medicare Bills Rise as Records Turn Electronic