Electronic Medical Records Enable Medicare Over-Billing
A typical visit to the hospital means practically an eternity of waiting. Doctors, who are overworked and overbooked, are rarely anything but way behind schedule. The emerging problem now, however, is being seen almost too quickly.
In an attempt to make health care more efficient and cost effective, the last two presidential administrations have been pushing for the adoption of electronic health records. Touted as the answer to all our health care problems, electronic records came with the promise of better care, lower costs due to unduplicated records. In order to implement these benefits in our current health care, billions of dollars have been invested in this plan. As policmakers have argued on behalf of electronic records, many have come out to criticize various flaws in the plans.
One of the major concerns about use of electronic medical records is the lack of security for such sensitive information. After the regulation of HIPAA and other health care privacy laws had been seared into health care professionals’ minds, it became very difficult for the industry to accept the idea of allowing personal health information to float around unsecured throughout cyberspace. In many people’s minds, using electronic records was a legal and ethical liability not worth the risks unless increased security measures were taken.
But, despite all the scrutiny electronic medical records have undergone, a crucial aspect has been overlooked: abuses by the doctors using the system. The system has received scrutiny in terms of who could misuse it from the outside, but there has been little to attention given to ensuring that those working from inside the system would be using it properly.
Recently, the percentage of high-cost billing toward Medicare and insurance companies has skyrocketed in correlation with use of electronic medical records and bills. What’s causing this is copy-pasting, or copy-forwarding of medical bills. Instead of actually completing a complete examination of the patient, doctors can recycle old forms. This unethical practice has led to an unmistakable increase in patient care costs, and is now, much too late, causing concern about the effectiveness of using electronic records.
As made obvious by the Dept. of Health and Human Services evaluation of Medicare billing patterns over the last decade, the issue of doctors incorrectly billing Medicare, as well as insurance companies, is not a new one. Long before the introduction of electronic medical bills, doctors have been scamming the system. Any profession has people who will try to work the system in their favor; it’s an unfortunate truth about our society and human nature. So, to create a billing system that not only allows but enables health professionals to make these kinds of blatant errors is not only negligent: it’s simply begging for trouble.
Beyond the financial harm of insurance and Medicare fraud, this unchecked billing system is leaving patients like Robert Burleigh in Virginia, with a sense of betrayal and apathy on the part of his doctors, who are supposed to care for his health. A victim of the lack of accountability the unregulated electronic billing creates, Burleigh went into the hospital with a kidney stone and received billing for a complete physical exam. People are reluctant enough to seek medical help, whether out of mistrust, lack of funds, or lack of understanding; the 1,700 doctors, less than 1 percent of the 440,000 doctors in the U.S., who have helped cause the Medicare payment to hospitals to increase by $1 billion in five years, aren't helping.
When it comes to people’s health and personal care, policymakers need to think beyond the rating and the good press they’ll get for promoting better care. Implementing new systems in health care, something that impacts everyone’s lives, should have more thought put into it; when the state of people’s lives are at stake, our medical system shouldn’t be undergoing a step by step renovation rife with glitches and setbacks. So, while the Obama administration is working toward the very admirable goal of allowing everyone the chance to receive health care, you have to wonder: is it worth the “non-care” some patients are getting?
Reach Contributor Zion Samuel here.