health care fraud

USA Today reports that the incentives being provided by the federal government to get doctors and hospitals to adopt electronic health records are being offered even though those EHRs "currently make it easier for health care providers to defraud government-paid health programs." The issue, according to USA Today, is that the EHRs don't have auditing safeguards in place to prevent fraud or the safeguards are "vulnerable to corruption" from providers adding unnecessary notes to existing records or creating new records where none existed before.

 The U.S. Department of Health and Human Services has spent $22.5 billion in financial incentives for healthcare providers to use EHRs, USA Today also reports.

An audit by the Department of the Health and Human Services' Office of Inspector General found that most hospitals don't have policies about copying and pasting health information in electronic health records, iHealthBeat reports. That could lead to health care fraud and abuse such as fraudulent billing and incorrect information being entered into patient records. Only 24% of hospitals had a policy regarding the "improper use of copy-and-paste functions within EHR systems," iHealthBeat further reports.

Separately, Government Health IT reports that earlier this month the Centers for Medicare & Medicaid Services decided to propose a delay in the next two stages of its program to incentivize healthcare providers to adopt "meaningful use" of electronic health records in exchange for governmental incentives.

The U.S. Supreme Court has decided against granting Pfizer's appeal of a $142 million award in favor of Kaiser Foundation's health plan and hospitals regarding the off-label marketing of the Neurontin epilepsy drug, Bloomberg Businessweek reports. The Supreme Court's action also means that a national class action can proceed in which insurance companies, union funds and employers are suing for paying for coverage of "ineffective dosages of Neurontin" on the basis of aggregate data showing a correlation between Pfizer's off-label marketing and the number of off-label prescriptions, Bloomberg Businessweek further reports.

The New Mexico Human Services Department is citing a law enforcement exception to that state's public records law as the reason it doesn't have to disclose an audit of 15 health-care providers; the audit was passed onto law enforcement, New Mexico In Depth reports. The lawyer for two New Mexico media outlets is arguing in court that this situation could set a "terrifying" precedent because it would "enable government officials to keep otherwise public documents from the public simply by passing them on to law enforcement agencies."