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Hospitals Warned by U.S. on Medicare Electronic Billing
By Alex Wayne – Sep 25, 2012 7:38 AM ET
Hospital bills are being audited as the U.S. tries to identify whether new electronic records were used to “game the system” and overcharge the Medicare health program.
Some hospitals may be “cloning” patient records and “upcoding” their bills — charging for higher intensity services than are given — to raise payments from the government, Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, and Attorney General Eric Holder said in a letter yesterday to five trade associations. Hospitals caught misusing the electronic systems may be prosecuted for fraud or lose Medicare payments, the officials said.
Encouraged by as much as $27 billion in incentives in President Barack Obama’s 2009 economic stimulus law, hospitals and doctors’ offices have been converting paper record-keeping systems to computers, an effort the administration said would reduce medical errors and save money. Instead, hospitals may be using the systems to increase their billings for Medicare, the federal program for the elderly and disabled, the U.S. said.
