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Two software makers have paid a total of more than $200 million to settle fraud allegations. Signs of fraud: Federal officials say the software can be misused to overcharge, a practice known as “upcoding.” Some doctors and health systems are alleged to have overstated their use of the new technology, a potentially enormous fraud against Medicare and Medicaid likely to take years to unravel. Yet no central database exists to compile and study these incidents to improve safety.
Alarming reports of deaths, serious injuries and near misses - thousands of them - tied to software glitches, user errors or other system flaws have piled up for years in government and private repositories. Patient harm: Electronic health records have created a host of risks to patient safety. Attorney Christina Nolan, calls the “frontier of health care fraud” - and prosecuting a first-of-its-kind case that landed the largest-ever financial recovery in Vermont’s history. Though it looked to be a standard medical malpractice case, Foster was on the cusp of discovering something much bigger - what his boss, U.S. attorney with the District of Vermont, was assigned to defend the government. Owen Foster, a newly hired assistant U.S. Monachelli’s husband sued Stowe, the federally qualified health center the physician worked for. Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief. The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions.
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This story can be republished for free ( details). Only certain images can be republished by partners. Erika Fry is an investigative reporter for Fortune. Fred Schulte is a senior correspondent for KHN. Kaiser Health News and Fortune Magazine collaborated on this joint investigation for three months.
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