D.C. Report: HHS OIG Looks Into EHR Fraud, Upcoding

Stakeholders Convene to Develop Input to FDA Report on Regulatory Framework  A range of preliminary recommendations – focus on the patient experience, integrate with existing initiatives, encourage voluntary reporting of problems and learn from other industries – were offered by  groups meeting earlier this week to explore how best to guide creation of a regulatory framework for Health IT, as called for by the FDA Safety and Innovation Act signed in July 2012.  Due January 2014, the report to Congress must include “a proposed strategy, and recommendations on an appropriate, risk-based regulatory framework pertaining to health information technology, including mobile medical applications, that promotes innovation, protects patient safety and avoids regulatory duplication.”  To inform this process, The Bipartisan Policy Center (BPC) convened over 60 organizations representing providers, clinicians, consumers, health plans, employers, patient safety organizations, and technology companies.  HHS itself may convene a working group of external stakeholders and experts to provide input, but the BPC effort is viewed as a means to gather early industry views outside of more formal government processes.  CHIME, as part of the BPC group, is interested in hearing your thoughts on how best to assure patient safety and quality while promoting the innovation required to meet the needs of our rapidly evolving healthcare system. 

The EHR Medicare and Medicaid Incentive Program has accelerated the adoption of health information technology by the nation’s providers, while at the same time attracting increased attention by lawmakers.  Further, the August 2011  Institute of Medicine’s  (IOM) Health IT and Patient Safety: Building Safer Systems for Better Care, called for improving safety in health IT indicating that safety is an “emergent property… of a larger system…. that includes technology (e.g. hardware, software), people (e.g. clinicians, patients), processes (e.g. workflow), organization (e.g. capacity, decisions about how health IT is applied), and the external environment (e.g. regulations, public opinion).  The July FDA legislation was seen as an opportunity to place more scrutiny on this entire area.  Meanwhile, Congressional attention will continue as seen in recent letters from Ways & Means and Energy & Commerce Leaders in the House calling on Secretary Sebelius to suspend payments under the Incentive Program.