OIG: CMS Should Develop Best Practices to Detect EHR Fraud

HHS' Office of the Inspector General has issued a report urging CMS to develop a set of best practices for its Medicare contractors on detecting fraud associated with electronic health records.

The advent of EHRs has created a myriad of new ways for healthcare organizations to present inaccurate, misleading or inflated information to CMS, including overdocumentation and the overuse of the copy-and-paste function. However, the report claims CMS has not done enough to update its investigative practices to respond to these new avenues to fraud.

The report recommends CMS reevaluate its best practices in regards to detecting fraud associated with EHRs, as well as ensure contractors use providers' logs of EHR activity to help uncover the source of fraudulent information.

CMS agreed new best practices were necessary and partially agreed with the recommendation to ensure the use of audit logs, according to the report.

The report is the second in as many months from the OIG on the vulnerabilities inherent in EHRs. In December, the agency released a report asserting hospitals that have received Medicare incentive payments for EHR use have not fully implemented all of the fraud safeguards recommended by ONC.

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