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● Industry Watch EHRS

HHS report says EHRs can distort info, infl ate health claims

A new report released by the Offi ce of the Inspector General for the Health and Human Services Department (HHS) Jan. 8, 2014, casts a distrustful eye on how electronic health records (EHRs) are used. T e report, “CMS and Its Contractors Have Adopted Few Program Integrity Practices to Address Vul- nerabilities in EHRs,” says that in digitizing medical records “certain EHR technology


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features may be used to mask true authorship of the medical record and distort information to infl ate healthcare claims. T e transition from paper records to EHRs may present new vulnerabilities and require the Centers for Medicare & Medicaid Services (CMS) and its contractors to adjust their techniques for identifying improper payments and investigating fraud.”

fth m di lr r Two actions are to blame, according to the report:

1. Copy-pasting information (also know as cloning). “When doctors, nurses or other clinicians copy-paste infor- mation but fail to update it or ensure accuracy, inaccurate information may enter the patient’s medical record and inappropriate charges may be billed to patients and third- party healthcare payers,” the report says. “Furthermore, inappropriate copy-pasting could facilitate attempts to infl ate claims and duplicate or create fraudulent claims.”

2. Overdocumentation. T e report describes this as “inserting false or irrelevant documentation to create the appearance of support for billing higher level services.”

Two recommendations are made: 1. “CMS should provide guidance to its contractors on detect- ing fraud associated with EHRs. CMS could work with contractors to identify best practices and develop guidance and tools for detecting fraud associated with EHRs.

2. “CMS should direct its contractors to use providers’ audit logs.”

Read the report and its recommendations in full at

INFECTIOUS AGENTS Copper-infused hospital wing aims to combat HAIs In a bid to win the war on hospital-acquired infections (HAIs),

Sentara Healthcare is banking on copper, which has long been known to possess natural antimicrobial properties, to be its se- cret weapon. In the United States, HAIs account for nearly 1.7 million infections and 100,000 deaths each year. A 2009 CDC study estimates the annual direct costs of HAIs between $35.7 billion and $45 billion. Opened on Nov. 16, 2013, the 129-bed East Tower at the Sen- tara Leigh Hospital site in Norfolk, VA, is a hospital wing where the patient rooms and most clinical spaces have been outfi tted with antimicrobial copper-infused surfaces, including countertops, over-the-bed tables and bed rails. In early 2014, Sentara will add antimicrobial copper-infused textiles, ranging from bed linens to patient gowns, throughout the entire new facility. T e use of the copper-infused surfaces and textiles will be part of an evaluation to determine whether they decrease the development of infections, and thus the need for antibiotics prescribed as a result of HAIs. T is will be the world’s largest-known study to date of durable, biologically active antimicrobial surfaces. T e secret to these materials is a copper technology developed

by Richmond, VA-based Cupron, a biotechnology company that has developed ways to isolate copper so that it can be stabilized and embedded in a variety of materials. Cupron partnered with EOS Surfaces in Norfolk, VA, to develop Antimicrobial Cupron En- hanced EOS Surfaces, which have been approved by the EPA for their ability to kill greater than 99.9 percent of harmful bacteria within two hours of exposure. It is the only copper-infused antimicrobial surface with this EPA-approved public health claim.

CMS proposes extending MU Stage 2; delaying Stage 3 MEANINGFUL USE

T e Centers for Medicare & Medicaid Services (CMS) and

the Offi ce of the National Coordinator for Health Information Technology (ONC) announced in a dual-authored blog post Dec. 6, 2013, a new timeline for implementing meaningful use for the Medicare and Medicaid EHR Incentive Programs. Under the proposal, Stage 2 will be extended through 2016,

and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. “T e goal of this change is two-fold: fi rst, to allow CMS and ONC to focus eff orts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to

6 February 2014

utilize data from Stage 2 participation to inform policy decisions for Stage 3,” the post stated. “T e phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3.” CMS anticipates the release of the proposed rulemaking (NPRM) for Stage 3 in the fall of 2014, including further details on the new timeline. T e fi nal rule with all requirements for Stage 3 would follow in the fi rst half of 2015. In the blog, ONC also proposed a more regular approach to updating certifi cation regulations. Read the full blog post at


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