Oh, the Games We Play

Remember how great EMRs were in helping you code better?  Well, now the government believes hospitals are using the EMR as a tool to “inflate payments or to exaggerate the intensity of treatments in order to reap profits from Medicare.”  Now this should scare you.  First of all, our coding system is a joke.  An ear infection could be a level three or four depending on how much you document.    You can game the system, which is wrong.  That being said, many systems are on self-pilot and basically code for us.  I am using one now.  That has got the government pissed.   Attorney General Eric Holder and US Health and Human Services Secretary Kathleen Sebelius have sent letters out to chief executives of five groups stating,  “We will not tolerate health care fraud.  Law enforcement will take appropriate steps to pursue healthcare providers who misuse electronic health records to bill for services never provided”.    What?  They are making this a criminal case?   Read the original NY Times article here.    What amazes me is that the coding system was created by the government but when it is used to its fullest by doctors it puts them at risk of going to jail.  Are you kidding me?

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