Electronic medical record (EMR) fraud is a significant problem that costs taxpayers millions of dollars and compromises patient care. EMR software was designed to streamline patient record storage and increase diagnosis accuracy, but instead has been embroiled in instances of fraud, waste, and abuse nationwide. Whistleblowers who report EMR fraud may receive a significant financial reward. Common types of healthcare fraud involving electronic medical records include kickbacks, meaningful use fraud, medical billing fraud, and misrepresentation of system capabilities. Reporting EMR fraud is crucial to ensuring accountability and protecting patients and taxpayers.
Electronic medical record (EMR) software was created to digitize and streamline the storage of patient medical records and improve patient care by making it easier for doctors to access vital information such as diagnostic tests, vaccination records, prescription drugs, and allergies. However, instead of revolutionizing the medical field, EMR systems have become embroiled in instances of fraud, waste, and abuse, costing taxpayers millions of dollars and compromising patient care. EMR software fraud takes place when medical providers certify that their EMR system meets minimum compliance standards when it does not, or when EMR software companies wrongfully claim compliance with these standards.
Common types of healthcare fraud involving electronic medical records include kickbacks, meaningful use fraud, medical billing fraud, and misrepresentation of system capabilities. Kickbacks involve offering incentives such as direct payments, discounts, or additional goods or services to hospitals to invest in a particular company’s software. Meaningful use fraud involves vendors and hospitals miscertifying non-qualifying EMR technology to receive government reimbursement. EMR systems can hide medical billing fraud, which can result in incorrect billing, ordering medically unnecessary procedures, and more. Vendors are required to appropriately portray the capabilities of EMR systems, and it has been documented that EMR software developers have written models expressly for certification testing.
EMR fraud harms patients by creating errors in medical records, suggesting medical options that are not in the patient’s best interests, advertising for non-generic or more expensive prescription options, failing to recognize dangerous drug interactions, and creating barriers to sharing information between providers. It also harms taxpayers by prioritizing profit over functionality and subsidizing fraud, waste, and abuse. Anyone with information about EMR fraud can become a whistleblower, and whistleblowers are protected from retaliation by their employers. If a whistleblower’s claim is successful, they may receive a financial reward under the False Claims Act.
Reporting EMR fraud is crucial to ensuring that hospitals and patients receive medical technology that works and that taxpayers get what they pay for. EMR whistleblowers can contact a qui tam law firm to see what evidence they will need to share to bring a claim and earn a possible reward.
