According to a  recent DOJ-HHS letter, hospitals are not doing enough to prevent electronic health records from being used to defraud Medicare and will likely face increased investigations and prosecutions. When I asked Joel White, the executive director of the Health IT NOW Coalition,  if the letter would cause hospitals to slow their EHR implementations to avoid trouble, he said it would probably lead them to adopt stronger compliance policies. "If I'm a hospital compliance officer and I get this letter, I'm going to immediately issue a memo about tightening up compliance policies surrounding EHRs," White said. White also said the administration is partly to blame for any fraud surrounding EHRs, due to the fact that it has not released updated coding standards.

The DOJ-HHS letter was sent to five hospital associations (the American Hospital Association, the Federation of American Hospitals, the Association of Academic Health Centers, the Association of American Medical Colleges, and the National Association of Public Hospitals and Health Systems) on Sept. 24, and identified several trouble spots around the use of EHRs, including upcoding and electronically duplicating a patient's EHR in order to increase Medicare billing. The AHA responded to the letter and urged CMS to release national coding guidelines to clear up any confusion.