Incentive Payments For Transition To Electronic Health Records: Is Medicare Being Defrauded?

In an effort to provide incentives to physicians, hospitals, and other health care providers to transition from paper health care records to electronic health care records, the  U.S. Congress enacted legislation in 2009 as part of the economic stimulus package to give physicians grants (money that is not paid back) in amounts of up to $44,000 and grants to hospitals in amounts of up to approximately $2 million to help pay the costs involved with the transition to electronic health care records, which grants are expected to cost taxpayers a total of $6.6 billion by the time the incentive program expires in 2016. Since 2011, about $4 billion have been paid to encourage medical providers to computerize their record-keeping systems.

A report by the Inspector General of the U.S. Department of Health and Human Services raises a serious warning regarding ways that the incentive program is vulnerable to fraud.  For example, in order to qualify to participate in the incentive program and to receive grants, health care providers must make “meaningfully use” of technology to improve health care and they must comply with specified criteria. An example of qualifying use of technology is implementing electronic prescriptions for patients.

A significant potential source of fraud is that health care providers are not required to prove that they are engaging in “meaningful use” of the technology that they allegedly adopted. The government has responded to the Inspector General’s report by stating that requiring and reviewing proof of implementation of technology would unduly delay the incentive payments to the health care providers.


Is it really too onerous, unexpected, or unreasonable to request and require doctors, hospitals, and other health care providers to provide some proof that they did what they said they would do as far as implementing meaningful use of technology in their medical practices before they receive free government handouts that they put in their pockets? In this day and age when each of us must remove our belts and shoes, empty our pockets, limit ourselves to minuscule quantities of liquids in our carry-on luggage, pass through metal detectors or subject our bodies to some form of intrusive scanning, and provide government-issued identification before we are allowed to board a flight in the United States, how are our sensibilities somehow offended by the notion that government-provided grant recipients may be required to prove they complied with the criteria for the free money before they are handed a check?

If you have any question or reservation in your mind whether doctors, hospitals, or other health care providers (including pharmaceutical companies) would commit Medicare fraud, Medicaid fraud, or other government program fraud, just read the daily news or search the term “fraud” on our blog page where you will find over 50 blog postings discussing fraud.

If you are aware of possible Medicare fraud, Medicaid fraud, or other U.S. government program fraud, you may be entitled to share in the recovery from the wrongdoers under the provisions of the False Claims Act. You may wish to contact a local false claims attorney who may be willing  to investigate your False Claims Act claim for you and assist you with your claim.

Click here to visit our website or call us toll-free at 800-295-3959 to be connected with False Claims Act lawyers in your state who may be willing to represent you.

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This entry was posted on Saturday, December 15th, 2012 at 3:14 pm. Both comments and pings are currently closed.


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