The Centers for Medicare & Medicaid Services (CMS) continues to feel pressure over “upcoding” and “cloning” that’s enabled by EHRs, after an HHS watchdog agency issued a report saying CMS and its contractors should do more to prevent fraud. Also, Congress continues to work on a permanent fix for the Sustainable Growth Rate (SGR) formula, which determines physician Medicare reimbursement rates.
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HHS Inspector General Wants More Attention on EHR-Related Fraud
Key Takeaway: The Centers for Medicare & Medicaid Services (CMS) continues to feel pressure over “upcoding” and “cloning” that’s enabled by electronic health records (EHRs), after a Department of Health and Human Services (HHS) watchdog agency issued a report saying CMS and its contractors should do more to prevent fraud.

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