Provide names of other journalists involved.
none
List date(s) this work was published or aired.
20-Jul-12
Provide a brief synopsis of the story or stories, including any significant findings.
This story reported on how physicians increased their use of higher-level and higher paying billing codes for so-called evaluation and management services for Medicare patients from 2001 to 2010, partly with the use of electronic health records (EHRs). The U.S. Department of Health and Human Services (HHS) suspects fraud and abuse was at play.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
Documents used included online reports from the Office of the Inspector General at HHS, an article published online by the New England Journal of Medicine, billing guidelines published online by the Office of Billing Compliance at Texas Tech University Health Sciences Center, a report on improper Medicare billing published online by the Centers for Medicare and Medicaid Services (CMS),a comparative billing report distributed to physicians by CMS, and an article on E/M billing published online in 2001 by the American Academy of Family Physicians (AAFP). There were no FOI or public record act requests.
Explain types of human sources used.
My sources included two medical coding experts, a leader of the AAFP, and an expert on EHRs,
Results:
After my story appeared, the Center for Public Integrity and the New York Times published investigations on the link between intensified E/M coding and EHRs, which in turn has prompted federal inquiry and threatens of prosecution. I’m not sure if my article sparked news coverage by other media outlets.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
None
Advice to other journalists planning a similar story or project.
Don’t be afraid of technically complex stories, which, in this case, involved the arcane worlds of medical coding and EHRs, because they inevitably boil down to basic and easily understood human themes such as greed.