Docs press AMA to 'educate' feds on EHR use

The New Jersey delegation to the American Medical Association's House of Delegates meeting next month wants the AMA to “educate” the CMS that the appropriate use of templates and cutting and pasting within an electronic health-record system is not tantamount to fraud.

The request comes in the form of a resolution proposed for the annual meeting of delegates (PDF) set for June 15-19 in Chicago. It was issued in response to a controversy that arose late last year when HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder jointly warned providers about rising levels of evaluation and management codes, suggesting EHRs might be used to fraudulently code patient encounters.

The New Jersey resolution said “federal enforcement authorities appear to have a presumption that any increased medical costs are the result of fraud and not the result of better documentation of clinical services provided.” It also called on the AMA to both “disabuse” the feds of that presumption of fraud and to “develop standards or guidelines on the appropriate use of templates and cutting and pasting that will facilitate accurate documentation resulting in better care.”

The New Jersey delegates appear to be preaching to the AMA's pastor, if not its choir. Earlier this month, AMA Board Chairman Dr. Steven Stack gave both a blistering critique of clunky EHR functionality as well as a rousing defense of physician EHR practices at a federally sponsored listening session on EHRs. Stack said copying and pasting historical patient information from a previous record, or the text of a “pithy” description of a condition written by that physician or a peer, makes physicians more efficient but does not constitute fraud.

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