According to the suit that was made public Thursday, the alleged glitch in the system has resulted in hundreds of millions of dollars of overbilling. Epic refutes the allegations.

"The Department of Justice did its own expert review and decided not to move forward," Epic spokeswoman Meghan Roh said in a statement. "The plaintiff's assertions represent a fundamental misunderstanding of how claims software works."

[...]

Geraldine Petrowski, who worked at WakeMed Health in Raleigh, North Carolina, between 2008 and 2014, filed the complaint that claims that Epic's billing software defaults to charging for both the applicable "base units" for anesthesia provided on a procedure as well as the actual time taken for the procedure, resulting in payers being overcharged for anesthesia.

"This unlawful billing protocol has resulted in the presentation of hundreds of millions of dollars in fraudulent bills for anesthesia services being submitted to Medicare and Medicaid as false claims," Petrowski said in the complaint.

She also seeks to bolster her case, alleging that MD Anderson Cancer Center billed for seven hours of anesthesia for a prostate removal that took less than five hours.

Petrowski served as hospital liaison for the WakeMed's rollout of Epic's software, when she came across the anesthesia billing issues, developing "major concerns" about incorrect billing, she said in the complaint.

She worked as a compliance review specialist at from September 2008 to September 2012 and then as the supervisor of physicians' coding through May 2014. In 2015, was the liaison for the hospital's Epic go-live.

Source: Healthcare IT News (View full article)

Catfishing, the practice of pretending to be someone else online, became a cultural phenomenon through MTV's popular TV show "Catfish," driving more attention to our obsession with our online personas. However, it's not just social media that needs additional scrutiny. In the wake of several recent major data breaches of personally identifiable information (PII) such as Social Security numbers, dates of birth and addresses, cybercriminals have all the information they need to catfish their way right into your financial life in a process called new account fraud (NAF).

Our identities are being used for much darker purposes than creating fake profiles to lure online suitors. Cybercriminals are increasingly using PII to commit fraud, and it's a big business. According to Javelin Strategy & Research, $112 billion was stolen globally through fraudulent means between 2009 and 2015, equating to $35,600 lost every minute. In 2016, identity fraud hit a record high with 15.4 million victims in the U.S. alone, up 16 percent from 2015.

This goes beyond what has unfortunately become a somewhat common occurrence of someone using an account to buy an expensive TV or 10 pairs of designer sneakers. Cybercriminals are getting savvier, leveraging stolen identity details to catfish banks and open completely new accounts under fake or stolen names and bypassing common red flags by waiting to use them. Javelin predicted that NAF will rise as much as 44 percent by 2018 in the U.S., increasing losses from $5 billion to $8 billion in just four years.

Source: IBM Security Intelligence (View full article)

Allscripts announced this week that four more hospitals have extended their Paragon EHR agreements with the company in the third quarter of 2017, following its acquisition of McKesson's Enterprise Information Solutions unit in August.

The Southern California-based KPC Group hospitals will innovate with Paragon, OneContent and other tools by selecting remote hosting and adding additional years of maintenance through a bundled offering, according to Allscripts.

Such a large expansion of its client base, coupled with sizable investments in innovation, will help "accelerate the connection of a greater number of communities," said Berner. "We know today how everyone is struggling with the sharing of information. This acquisition helps us solve some of those interoperability and care integration problems that have been plaguing the industry."

Source: Healthcare IT News (View full article)

A team from IBM Research claims to have made a breakthrough in computational memory by successfully using one million phase change memory (PCM) devices to run an unsupervised machine learning algorithm. Details of the research have been published in the journal Nature Communications.

The IBM team's PCM device was made from a germanium antimony telluride alloy stacked and sandwiched between two electrodes. "[T]his prototype technology is expected to yield 200x improvements in both speed and energy efficiency, making it highly suitable for enabling ultra-dense, low-power, and massively-parallel computing systems for applications in AI," according to a post on IBM Research's blog.

Source: Futurism (View full article)

A group of United States Senators on Thursday put forth legislation intended to reduce the burden that using EHRs and attesting to the meaningful use incentive program put on doctors.

"Our bill ensures that unnecessary regulatory burdens do not continue to negatively affect providers' ability to leverage technology to improve patient care," said Senator John Thune, R-South Dakota. "With such strong and continued support for this legislation, I'm hopeful it will lead to swift and meaningful action in the Senate."

[...]

The EHR Regulatory Relief Act also extends flexibility for providers seeking hardship exemptions for the 2017 EHR reporting period and payment adjustments for 2019.

"The use of electronic health records has the potential to revolutionize patient care," Enzi said. "But if we want electronic health records to work for providers and patients, we have to provide relief from unrealistic and burdensome requirements and build flexibility within the program."

Source: Healthcare IT News (View full article)

The bundle of emerging technologies that comprises artificial intelligence is driving the creation of new tools and practices, impossible to conceive of until now. Gartner's position is that any IT leader can apply AI as it exists today, without needing advanced degrees in AI's many disciplines. What CIOs and IT leaders need most is practical intelligence -- they need to get smart to assess AI's potential and prepare their organizations to leverage it.

This Special Report helps you understand where to begin, right now, to make sense of the AI opportunity for your business and the practical steps to realize business value for your organization.

Source: Gartner (View Video)