Preventing Fraud and Abuse in Clinical Documentation
Jul27

Preventing Fraud and Abuse in Clinical Documentation

In this month’s installment of HIM Frontlines, Felicia E. Heimer, Office of Counsel to the Inspector General, spoke with Journal of AHIMA to help give HIM professionals an idea of how the federal government is approaching healthcare fraud, and to offer advice on steps for maintaining compliance.

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Leveraging Data and Analytics to Detect Fraud and Abuse in Healthcare

According to the Institute of Medicine (IOM), fraud and abuse in healthcare contribute to as much as $75 billion in costs each year. In fact the Centers for Medicare and Medicaid Services (CMS) estimates that fraud and abuse add up to 10 percent to the total expense of a Medicare claim. That amount would fund NASA’s budget for 15 years.

Moderator Jennifer Covich Bordenick, chief executive officer, eHealth Initiative discussed ongoing efforts to combat fraud and abuse with an esteemed panel including Michael Nelson, vice president of strategy and business development, Equifax identity and Fraud Solutions; John Benson, chief operating officer and co-founder, Verisys; Gerald Cliff, research director, National White Collar Crime Center; Melanie Endicott, senior director of HIM practice excellence, AHIMA; and Mark Isbitt, director of market planning, LexisNexis. The panel met and discussed during today’s session of the CDI Summit held in Washington, DC.

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Health Data Increasingly at Risk for a Cyber Attack, Experts Contend

The healthcare industry’s late-to-the-party approach to cybersecurity renders patients’ and providers’ protected health information (PHI) vulnerable to data terrorists, healthcare security experts warn.

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OIG Issues Hospital EHR Fraud Survey

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.

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A Consumer Checklist for Medical Identity Theft

Medical identity theft is a fast-growing and lucrative form of identity theft. The Journal’s July practice brief offers guidance on how HIM professionals and others can work together to prevent, investigate, and mitigate the damage that such theft causes. The brief also offers a downloadable checklist for individuals who have been the victims of medical identity theft. The checklist includes steps consumers can take in response to a...

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