Medicare Officials Raise Issue of Fraud as Greater Use of Electronic Health Records Increases the Number of Claims Upcoded to More Complex CPT Codes

Issue does not directly affect clinical laboratories and pathology groups, but puts spotlight on some hospitals and physicians who frequently use these codes. Could increased use of electronic health records (EHR) systems be causing more hospitals and physicians to commit fraud because of upcoding? That’s the assertion of certain federal health officials. They attribute the increased proportion of Medicare claims for more complex and more expensive services by some providers to be, in some...

WellPoint’s New Pay-for-Performance Program to Pay Hospitals More for Meeting Quality Measures

Private payers taking first steps on a path toward value-based purchasing that could eventually include clinical pathology laboratory testing services Pay-for-performance just took a leap forward with news that one of the nation’s largest health insurers will link hospital reimbursement to specific quality measures. This development could be a precursor to similar payer initiatives that involve how private payers reimburse clinical laboratories and anatomic pathology groups. Indianapolis-based...

Hospital CIOs Pessimistic about Pace of EHR Adoption, as Numbers Show Mixed Story

CIOs across America are concerned that their hospitals might not make the 2015 meaningful use deadline For all the excitement about hospital and physician adoption of electronic health record (EHR) systems, many CIOs of the nation’s leading health systems and hospitals are pessimistic about their organization’s ability to meet “meaningful use” (MU) requirements by the year 2015. This is probably not news to most pathologists and clinical laboratory managers working in hospital laboratories....