Computerized Medical Records open the Door to Fraud and Give Glimpse of Health Care under Obamacare

Posted by PITHOCRATES - September 29th, 2012

Week in Review

One of the ways to improve efficiency and cut costs in health care is to digitize medical records.  President Obama and the Democrats kept talking about that as they pushed Obamacare through a Democrat-controlled House and Senate.  This simple fact was going to fix so much that was wrong with health care in the U.S.  Putting all our personal information online is just common sense.  Because it makes it so much easier for health care providers to look up our personal information no matter where they are.  And as it turns out, it makes it easier for others to pull up that personal information (see Feds warn hospitals over Medicare fraud by Associated Press posted 9/24/2012 on CBS NEWS).

Computerized medical records were supposed to cut costs. Now the Obama administration is warning hospitals that might be tempted to use the technology for gaming the system.

Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder issued the warning Monday in a letter to hospital trade associations, following media reports of alleged irregularities.

The letter said there were indications that some providers were using computerized records technology to possibly obtain payments to which they were not entitled. It raised the threat of prosecution.

Among the practices under scrutiny is what’s called “upcoding” — or raising the severity of a patient’s condition to get more money.

The U.S. spends about $770 billion annually on Medicare based on a recent CBO projection.  Imagine the fraud in the system when the government takes over all $2.6 trillion of health care spending.  If the spending increases by 238% one can assume the fraud will increase by 238%.  Fraud made easier by the digitizing of our health care system.  Unless, of course, the U.S. will have the best cyber security in place like they do for Medicare.

Hospitals say part of the problem is that Medicare has lagged in updating billing guidelines for emergency room and clinic visits.

Getting the billing guidelines in place is probably the easier part of a computerized billing system.  Probably a lot easier than securing that system from cyber attacks.  So it doesn’t give one a strong sense of confidence that our personal information will be safe online.  Especially when the government goes from processing $770 billion annually to processing $2.6 trillion annually.

Obamacare may make it easier for doctors to access all our personal information.  But it will also make it easier for everyone else to access our personal information.  Including those we don’t want seeing our personal information.  Those who want our social security number.  Address.  Phone numbers.  Addresses and phone numbers of our family members.  As well as our personal medical history.  All of which will be one click away for those who would really like to have it.  Makes you yearn for the old days.  When only your family doctor had that information.  On a paper file.  In his or her file cabinet.  Safe and secure.  Even if it was not the most efficient system in the world it was one you didn’t have to worry about.

Sadly, those days are long gone.  For Obamacare will put your health care experience on the public stage.  Where little will be secure from prying and persistent eyes.  Where the same people will be responsible for your personal information that can’t stop Medicare fraud.

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