Electronic Health Records and EHR Billing Arrangements: Ensuring Stark and AKS Compliance, Minimizing Fraud and Abuse Risks

With the adoption and expansion of EHR, fraud is a top concern, and the government is focusing on the issue. Two primary issues are upcoding charges and cloning. CMS has noted an increase in upcoding from physician offices and hospital emergency rooms. Cloning, which allows end users of EHRs to select information from one record and replicate it in another record, can result in inflated claims, incorrect documentation, and fraudulent billing.

Healthcare providers and hospitals should carefully adhere to processes and procedures when interacting with EHR systems. Healthcare providers must take steps to ensure their records are complete and accurate. OIG’s continued focus on EHR fraud highlights the importance for healthcare professionals and hospitals to develop strategies to mitigate EHR fraud risk.

Listen as our authoritative panel of healthcare attorneys examines the fraud and abuse concerns with EHR and billing arrangements, discusses Stark Law and AKS and the applicable exceptions, and reviews recent cases and government guidance. The panel will discuss best practices for compliance and mitigating fraud and abuse risks.

1. Fraud and abuse concerns
   1. EHR arrangements
   2. EHR billing arrangements
2. Stark Law and AKS and the applicable exceptions
3. Recent cases and governmental guidance
4. Compliance and mitigating fraud and abuse risks

The panel will review these and other noteworthy issues:

• What are the fraud and abuse risks involved in EHR arrangements and EHR billing arrangements?
• What steps can healthcare providers take to mitigate fraud and abuse risks associated with EHR?
• What are the critical elements of an effective compliance strategy?