As we continue to roll out product changes to help our customers manage CMS’ ever changing policies, I thought this article in the New York Times emphasized what nearly every new policy is about. CMS is very serious about getting their arms around fraud. And, poor billing practices and mistakes in documentation are equivalent to fraud. For CMS, EHR adoption is desired, but not if it is used to systematically ‘upcode’ the level or quantity of services billed.
Two critical numbers, mentioned in the article:
- Prosecutions for fraud are up 75% since 2008
- Settlements from prosecution in 2011 amounted to $2.4 billion
All this really emphasizes why in our upcoming Webinar on Surviving the Medicare Therapy Cap, one of the key points is, “Compliantly converting the therapists time into Medicare billable units.”
Hope to see you there!



