The Justice Department's Focus on EHR Systems: Avoiding Government Scrutiny

Litigation attorneys Jessica Sievert, Henry Leventis, William Brady and Wesley Martinez co-authored an article for Chief Healthcare Executive breaking down the U.S. Department of Justice's (DOJ) new enforcement initiative focused on civil healthcare fraud under the False Claims Act (FCA) and sharing best practices for avoiding government scrutiny in relation to electronic health records (EHR). The DOJ announced a new False Claims Act Working Group, a collaboration with the U.S. Department of Health and Human Services Office of the Inspector General (HHS OIG), this July. One of the group's six priority areas is EHR manipulation, which raises questions for healthcare entities that commonly use revenue optimization tools and integrate artificial intelligence (AI) into billing and coding processes. The authors stress that merely using these tools is not problematic; rather, lack of oversight and compliance features is what exposes companies to liability. This article reviews recent civil and criminal cases brought by the DOJ illustrating these concerns along with highlights pointers for businesses when selecting and rolling out these tools as well as training employees on how to properly use them.

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