ONC Advisory Group to Probe Effect Of EHR Systems on Medicare Claims

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Members of a federal advisory committee are investigating how the “meaningful use” program is affecting the way clinicians document Medicare services, members of the committee told BNA.

The Health Information Technology Policy Committee, which advises the Office of the National Coordinator for Health Information Technology, has been tasked with determining whether the increased use of electronic health record systems as a result of the meaningful use program is causing clinicians to document more expensive Medicare services, Paul Tang, vice chair of the committee, told BNA Oct. 17.

“We're looking at everything related to documentation because … documentation is a major part of [electronic health records],” Tang said.

National Coordinator for Health Farzad Mostashari asked the committee at an Oct. 3 meeting to start the investigation, Tang said.


The concern is that providers may be using EHRs to improperly submit Medicare claims with codes for higher severity patient problems than were actually true, National Coordinator for Health IT Farzad Mostashari said.  

The concern is that providers may be using EHRs to improperly submit Medicare claims with codes for higher severity patient problems than were actually true, Mostashari said at the Oct. 3 meeting.

“The implication there was that the government's incentive program, to encourage adoption of electronic health records, may have had the opposite effect than desired by increasing costs by increasing the distribution of severity codes,” he said.

The request came in the wake of a Sept. 24 letter from Department of Health and Human Services Secretary Kathleen Sebelius--who oversees ONC--and Attorney General Eric Holder, warning that providers may be using EHR technology to engage in illegal Medicare billing practices (see previous article).

Meaningful Use and Documentation.

The meaningful use program is designed to reduce the administrative burden on clinicians and the cost of health care services by automating the documentation of health care services, Tang said. But that process has some concerned about the accuracy of EHR notes and the documentation the systems produce, he said.

Nearly 75 percent of clinicians have reported multiple errors in the EHRs they work with, compliance experts say (see previous article).

But some think EHR systems may be doing a more effective job of documenting services that clinicians might not have billed Medicare for in the past because they were not effectively capturing the information needed for claims, Neil Calman, a Health IT Policy Committee member and president and chief executive officer for the Institute for Family Health, told BNA.

More accurate documentations would mean fewer rejected Medicare claims and would make clinicians more inclined to bill for more expensive services that were legitimately provided, he said.

“This could be people documenting their work better,” he said.


The Policy Committee will hold hearings on Medicare documentation and EHR systems in coming months, Tang said.

The group will ask experts from private industry to advise on what changes could be made to the meaningful use program to ensure accurate documentation of claims and services, he said.

“We'd like to know what tools produce accurate records,” Tang said.

The Health IT Policy Committee will meet next on Nov. 7 in Washington.

By Alex Ruoff  

The letter from HHS Secretary Kathleen Sebelius is available at http://op.bna.com/hl.nsf/r?Open=jswn-8ygjsh.