The electronic health record (EHR) fraud ordeal in Texas, where a former hospital CFO is being charged with laying about using certified EHR technology to receive incentive payments from the Centers for Medicare and Medicaid Services (CMS), has gotten the attention of the House Committee on Energy and Commerce.
The committee, led by several Texans, including Vice Chairman of the Health and Oversight and Investigations Subcommittees Michael C. Burgess, M.D. (R-TX), and Chairman Emeritus Joe Barton (R-TX), recently sent a letter to CMS' Chief Administrator Marilyn Tavenner and Department of Health and Human Services (HHS) Inspector General Daniel Levinson. They are asking for the agencies to look at how they detect fraud around attestation for certified EHR use.
The letter talked about the recent news surrounding Joe White, the former hospital CFO for Tariq Mahmood's, M.D. now collapsed hospital chain, including Shelby Regional Medical Center (Center, Texas). White is alleged to have made it seem like Shelby Regional had transitioned from paper to electronic records. He directed the software vendor, not named in the indictment, and hospital employees to manually input data from paper records into the EHR, months after the patient was discharged and after the end of the fiscal year.
“The case in Texas raises broader questions about CMS’ ability to detect fraud in its programs,” the letters, signed by Congressmen Barton and Burgess, and co-signed by Committee Chairman Fred Upton (R-MI) say. They demanded that the CMS respond to the Committee members by March 12 to determine the status of CMS efforts on predictive modeling to determine characteristics of providers, reveal the accomplishments of a program to screen third-party contractors, and how the CMS has screened providers using the General Systems Administration database on contract exclusions. There are other demands on fraud detection credibility as well. The entire letters to the CMS and the Office of the Inspector General can be viewed online.
"Given these reports (in Texas), we have every reason to be concerned about how facilities are being screened and what processes the administration has to detect and prevent fraud,” Burgess said in a statement.