Physicians Use EMR Software to Overbill Medicare, Government Officials to Investigate

Accusations came to light recently regarding healthcare professionals taking advantage of their electronic medical record technology to defraud the system and overbill Medicare. The issue gained traction last month after the New York Times featured a front-page story about the rise in Medicare billing and physicians upcoding for Medicare services. Upcoding refers to the selection of higher-paying treatment codes.

In response to the charges, which claim that EMR software is making these instances of fraud possible, the National Coordinator for Health IT, Farzad Mostashari, has said that he and other government agencies will be investigating the matter further.

Aside from upcoding, one of the biggest problems that officials will be looking into, according to Mostashari, is “cloning.” Physicians who practice cloning cut and paste information from older notes into newer records in order to bill for services that never actually occurred. While this practice might be made easier through electronic medical record software, EMR software is not to blame. Ultimately, it is the physician who is making the conscious decision to cheat the system. After all, when a murder is committed, we blame the person and not the weapon – and the same reasoning can be applied here.

Though EMR software has the ability to help physicians increase billing, by streamlining workflows and maximizing office productivity, the technology’s main goal has always been about improving patient care. When healthcare professionals choose to defraud the system, the blame in doing so is entirely theirs, and it should not lessen the prestige of a piece of technology that is changing healthcare for the better.