Attorneys Analyze DOJ Initiative on Healthcare Fraud and EHR Best Practices
TL/DR –
The U.S. Department of Justice’s (DOJ) new enforcement initiative on civil healthcare fraud under the False Claims Act (FCA) includes a focus on electronic health records (EHR) manipulation. The DOJ has formed a False Claims Act Working Group, in collaboration with the U.S. Department of Health and Human Services Office of the Inspector General (HHS OIG). The group prioritizes oversight and compliance features in EHR systems to avoid liability, advising businesses to properly select, roll out, and train employees on these tools.
US DOJ’s Enforcement Initiative on Civil Healthcare Fraud
Article authors and litigation attorneys Jessica Sievert, Henry Leventis, William Brady, and Wesley Martinez shed light on the U.S. Department of Justice’s (DOJ) enforcement initiative addressing civil healthcare fraud under the False Claims Act (FCA). The DOJ recently introduced a new False Claims Act Working Group, in collaboration with the U.S. Department of Health and Human Services Office of the Inspector General (HHS OIG).
This group aims to tackle six priority areas, including the manipulation of Electronic Health Records (EHR), a common practice for healthcare entities that use revenue optimization tools and incorporate artificial intelligence (AI) into their billing and coding processes.
Though the use of these tools alone isn’t an issue, the absence of proper oversight and compliance is what leads to liability. The authors emphasize the need for businesses to exercise caution while choosing, deploying these tools, and training their staff to use them aptly, to avoid government scrutiny.
The article also presents recent civil and criminal cases brought forward by the DOJ. These cases serve as examples of the issues and liabilities that could arise from non-compliance and misuse of EHR systems.
Click here to read more about the DOJ’s Focus on EHR Systems and how to avoid government scrutiny.
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