Upcoding flap threatens the future of EHR incentives

We talk to the Pulitzer-Prize-nominated journalist whose stories laid the groundwork for Congressional calls to suspend EHR incentives.

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Four-time Pulitzer Prize finalist Fred Schulte, most recently of the investigative journalism organization The Center for Public Integrity, concluded two years' worth of work on Medicare coding-based fraud. He studied how electronic health record (EHR) systems and cloned documentation can be used to upcode episodes of patient care.

In this podcast, he tells the story of his series of articles titled "Cracking the Codes," whose content likely helped set in motion recent letters from Republicans in both houses of Congress requesting that HHS Secretary Kathleen Sebelius suspend the EHR incentives program. Schulte's group, at one point, sued the CMS to get billing data and won. He shares his thoughts on how far he thinks Congress may go in influencing EHR incentives, and how election-year politics play into it.

Let us know what you think about the story; email Don Fluckinger, Features Writer or contact @DonFluckinger on Twitter.

This was first published in November 2012

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