Health 2.0 Conference Talks About EHRs and Related Problems

The Health 2.0 Conference, which provides business leaders, entrepreneurs, investors, and developers in healthcare with the resources and connections to create innovative businesses around healthcare, wellness, and health IT, recently released some of the highlights from its 2022 conference in Las Vegas, USA. A few panelists discussed the role of electronic health records (EHRs) in improving healthcare delivery and how physicians can use EHRs to reduce the number of electronic medical scams they encounter daily. At the same time, they also discussed the flipside of banking on EHRs. 

EHRs were meant to improve the efficiency of a patient’s health records. They were intended to provide easy access to patients’ health records like histories, prescriptions, lab tests, and other health documents. It was aimed to share and deliver portable sharing of patient data with other healthcare providers if needed. However, the lack of regulations and standards can allow fraudsters to take advantage of these EHRs and negatively impact patients’ health.  

EHRs didn’t only face technical issues, but mismanagement of medication records led to patient dosage fluctuations. Bugs or the system’s incompatibility lead to ignorance of critical situations, whereas false alarms make clinicians miss essential warnings. The poor interface and buggy codes resulted in unreliable data collection and storage. These functionality issues encouraged scammers to indulge in EHRs scams, as highlighted at Health 2.0 Conference. Let’s dive deeper into how vendors and providers are availing undue benefits of this situation. 

EHRs & Associated Fraudsters, Highlights Health 2.0 Conference

EHR vendors and providers may commit a scam while trying to game the system in order to gain payments to which they are not entitled. Many healthcare experts at Health 2.0 Conference underlined how fraudulent providers submit fake claims for achieving EHR incentives. They either settle claims for misrepresenting their usage or misstating the system’s functions in operation. 

Electronic Health Record vendors may face liability for fake payment claims to the government, even though the EHR providers do not receive such incentives from the government. These providers have settled cases claiming that they fraudulently gained certification for their software, which did not meet HHS standards. 

Many EHR companies have created unique software versions for undergoing the required certification testing. Even when they knew that their software implemented for providers would function differently. 

Health 2.0 Conference Sheds Light On Frauds Associated With EHRs

• Certification Fraud

As discussed earlier, the U.S. Department of Health and Human Services (HHS) sets specific requirements and criteria for EHR software practices. The federal government has placed aside dollars as government incentives for those who fulfill the HHS standards. Many companies commit EHR fraud to obtain government certification by misrepresenting the capabilities of their systems. 

• Illicit Kickbacks 

The second major EHR fraud is when EHR companies pay illegal kickbacks for encouraging healthcare providers to use their software. Although according to the Anti-Kickback statute, paying kickbacks for getting their software used by other professionals is strictly prohibited. A lab, diagnostic facility, or another provider may offer discounted software programs to providers. Healthcare experts at Health 2.0 Conference shared that scammers do all this to get more patients as referrals.  

• Fraud In Billings 

Many healthcare professionals at the Health 2.0 Conference suggested that EHRs might result in inaccurate and fake billing. Let’s discuss the methods used in these fraud billings. 

• Upcoding occurs when the provider exaggerates the patient’s provided services to expensive diagnoses or procedures. This helps them in showing more acute and costly treatments for the patient. Also, it becomes a compulsion for patients to make regular and more visits. 
• Another billing scam is when there is a separate billing for procedures that should have been billed as a bundle. This practice is known as unbundling. In which the healthcare provider can include different procedures under one code. To gain more money, they create other codes. 

These were some of the common frauds and scams related to EHRs. But if we dig deeper to know, the major cause for these EHR-related frauds is this technology’s lack of vigilance and functionality. Although it was intended to fill the patient and provider’s communication gap, the bugs make it difficult. Let’s learn about the various steps discussed at the Health 2.0 Conference that can be taken to prevent these EHR frauds. 

Ways To Prevent EHR Fraud, Suggested at Health 2.0 Conference

• Make EHR Systems More Efficient 

The primary step would be to make the needed upgrades in the EHRs to encourage providers to use them. If they are efficient enough, companies would not have to indulge in scams to sell their EHR systems. Once they can sell them to providers, they’ll automatically get government incentives. It is why health experts at the Health 2.0 Conference stressed improving EHRs. 

• Focus On The HSS Standards Before Certification

Some government authorities have to check the EHR software’s inspection process and standards so that nobody gains fake certification. If there were fines or punishment for fraud certifications, other companies wouldn’t get into this illicit act. It is not just against the laws but is harmful to the patients, emphasizes healthcare professionals at Health 2.0 Conference. It is why strict actions need to be planned against the fraudulent violators.  

• Keep A Constant Check On EHR Companies & Providers

Many times, there is a visible connection between companies and providers, which makes it genuine that something is cooking. One can dive deeper to know whether they have unlawful kickback exchanges. If yes, actions can be taken. Clarity on anti-kickback policies should be given to the companies and providers, as it promotes wrongdoings at the cost of patients.  

• Review The Billings

As billing is essential for the patients and providers, cross-checking must be involved. It would discourage people from implicating billing scams like upcoding, unbundling, or many other prescription frauds. Strict instructions must be implemented in the billing department as these bills can significantly affect people, insurance companies, and the government. Much money is lost due to these billing scams, thus jeopardizing state funds. Actions taken at the lower levels can save people as a whole community. 

These are the few ways by which we together can prevent healthcare scams. It is very crucial as they not only cost us a loss of money but wrong decisions can affect someone’s life. It is why we need to be more alert and careful regarding health, states professionals at Health 2.0 Conference.