OIG Issues Hospital EHR Fraud Survey

Correction: This article was updated on Oct. 31 to correct inaccurate information. The OIG survey is voluntary for hospital recipients. The Journal regrets the error.

The Department of Health and Human Services’ Office of Inspector General (OIG) has issued a new fraud survey for hospitals that have received incentive funding under the ARRA-HITECH meaningful use EHR Incentive Program.

The survey, due on Friday, October 26, consists of 19 pages and 54 questions covering a wide range of topics—from EHR use habits, to security protocol, to meaningful use attestation methods. Media reports indicate that hospitals began receiving the OIG survey the week of Oct. 15.

Hospitals should respond before the deadline, though the survey is not mandatory. Enterprise systems can respond once for the entire organization and extensions may be accepted if OIG is directly contacted.

Recently OIG announced their intent to audit healthcare organizations receiving meaningful use payments as part of the FY2013 operations plan—which includes a report on this issue.

Possible fraudulent practices under investigation include:

  • Cut-and-paste activities (copy information from one patient to the next) and potential provider policies supporting cut-and-paste
  • Organization coding practices
  • Documentation practices and processes for clinician notes (in order to analyze E/M practices)
  • How the organization meets meaningful use requirements
  • How computer-assisted coding is used by the organization

 

In addition to asking specific reimbursement and incentive rules questions related to fraud and abuse , the survey also asks providers to answer questions related to HIPAA compliance, auditing processes, and logs.

Other survey questions ask for information on policies that allow outside entities to access a provider’s EHR, such as health plans or other payers. The survey serves as a wake-up call to all providers that the federal government is monitoring claims for fraud, and that one should always be prepared for an audit, AHIMA officials said.

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