Archive for June, 2013

Inaccuracies in Medicare and Medicaid Provider Data Highlighted

Friday, June 28th, 2013 | Permalink

A May 2013 Office of Inspector General for the Department of Health and Human Services report* analyzed the Provider data files of Medicare and found a very high error rate.

To quote portions of the Executive Summary:

“Medicare provider data in NPPES (National Plan and Provider Enumeration System) and PECOS (Provider Enrollment, Chain and Ownership System) were often inaccurate. In NPPES, provider data were inaccurate in 48% of records…. in PECOS, provider data were inaccurate in 58% of records…Addresses, which are essential for contacting providers and identifying trends in fraud, waste, and abuse, were the source of most inaccuracies and inconsistencies. Finally, CMA did not verify most provider information in NPPES and PECOS….(more…)

Electronic Medical Record Successful Usage –Fact or Figment?

Wednesday, June 5th, 2013 | Permalink

Recently Health and Human Services announced that it had exceeded its target of Electronic Medical Record (EMR) implementation by paying more that 50% of ‘Eligible Professionals’ almost $6 billion in incentive payments (with more to come)based on their ‘Meaningful Use’ of EMR systems. All of this effort is an outgrowth of the requirements in the American Recovery and Reinvestment Act of 2009 (ARRA), the so-called Stimulus Bill.

Indeed this can be seen as a milestone in the overarching effort to migrate the healthcare industry to EMRs but more importantly introduce interoperability between healthcare parties for EMR transmissions via Health Information Exchanges (HIEs).

Moreover the industry, which is the beneficiary of the incentive payments, has by and large endorsed the program.

But, is this an unqualified success? There do appear to be several considerations that might temper this ‘success’. (more…)


June 2013
« Apr   Jul »