AHA Presses Feds on Compliance Issues With EHRs and Billing

American Hospital Association President and CEO Rich Umbdenstock has sent a letter (pdf) to HHS and the Department of Justice, asking how hospitals can better improve the use of their electronic health records when billing Medicare and Medicaid.

The AHA’s letter comes almost two months after HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder wrote to five major hospital associations, including the AHA, saying the government “will not tolerate healthcare fraud” that may occur from EHRs and upcoding.


Specifically, Mr. Umbdenstock said there are three areas where hospitals and the federal government need to collaborate in order to comply with “Medicare’s and Medicaid’s complex billing requirements”:

•    Development of national guidelines for hospital coding of evaluation and management services provided in clinics and emergency departments.
•    Greater understanding of functionalities that vendors embed into EHRs and other automated tools used by hospitals.
•    Further discussion of law enforcement concerns with the goal of jointly developing compliance guidance for hospitals.

“Hospitals share the administration’s goal of a health system that offers high-quality, affordable care and work hard to ensure billing is correct the first time,” Mr. Umbdenstock wrote. “We look forward to working with you and other stakeholders as we continue to improve healthcare for patients.”

More Articles on Hospital Billing and EHRs:

AHA's Rich Umdenstock Writes Letter to New York Times on Hospital Billing

Hospital Associations Respond to Letter About Upcoding From HHS, DOJ

HHS, DOJ to Hospitals: Don't "Game the System" With EHRs

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