Government will increase EHR upcoding audits, Tavenner says

Marilyn Tavenner

The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, Acting CMS Administrator Marilyn Tavenner said Tuesday.

Speaking at the Federation of American Hospitals conference in Washington D.C., Tavenner said CMS remains committed to electronic health records despite its belief that they can aid in upcoding, according to the Bureau of National Affairs. Providers can expect CMS to undertake “small, targeted audits” to address the issue, Tavenner said.

While Tavenner specifically cited the biggest offenders as being physician's offices and emergency rooms, long-term care providers also have been cited for upcoding by federal watchdogs. Despite this issue, data sharing enabled by electronic recordkeeping is driving the success of multipayer groups that include hospitals and skilled nursing facilities, Director of the Center for Medicare Jonathan Blum told a Senate committee last week.