EMR frauds – the Issue Needs Attention!

Fraudulent use of Electronic Medical Records (EMRs) is under a lot of scrutiny within the healthcare industry. From health IT consultants to healthcare professionals to government’s regulatory bodies, almost everyone has taken the matter seriously. After all, EMRs were designed to ensure precision and quality in care delivery and never to encourage any fraudulent occurrences.

Considering the extent of fraudulent use of electronic medical records, it would not be difficult to proclaim that some healthcare professionals have deviated from the axiom of transparent provision of quality care at low cost. Moreover, it would certainly be “unreasonable” to blame the CMS’ financial incentive programs for instilling the urge of cheating and greediness amongst physicians.

It is important to realize that the financial incentives were offered on the basis of Meaningful Use of certified EMRs and I quote, “in a legal manner”.  According to official reports of HHS, 92 defendants including doctors, nurses, and other healthcare providers have been alleged for fraudulent use of EMRs related to billing purposes – resulting in $225 million for the Medicare funds. (For more details visit HHS).

According to the billing reports of the past decade, it becomes evident that physicians have been biased in submitting medical bills. The clinical procedures that resulted higher in monetary benefits were significantly given more priority, while the ones with negligible benefits were ignored. (Source: Fierce EMR)

Furthermore, it would also be absurd to blame the EMRs for these fraudulent occurrences. When it comes to IT products, some glitches and technical errors do exist but that doesn’t mean that they create a gateway to illegal usage. At the end of the day, the idea of usage, by all means depends upon the intent of use of healthcare providers.

Farzad Mostashari, the national coordinator for Health IT, says that there have always been people who commit frauds and there are always going to be enforcement against these frauds. In addition, lauding the significance and not blaming the EMRs, he proclaimed that it is such technology that constructs the base of stronger investigations and enforcement.


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