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Don B, 1/14/2013 - 5:02pm
"Oklahoma and Mississippi too? What do the two states, one ranking near the bottom in education and health care, have in common? Apparently, it's the acceptance of "negative charting" in health care as "good faith" performance of state employee duties in the first case, and "proper" in the second. "Negative charting" has at least two different definitions in health care.  It can be a) not recording ordinary or normal conditions on a patient's chart, or b) doing exactly the opposite, and recording normal results which would be "negative" indications of illness, or c) emphasizing only negative aspects of the patient's condition in order to ensure insurance payments.  Depends on who you ask. Since at least 1995, both Congress and the U.S. Government Accounting Office have recognized definition (c) as health care fraud. See GAO Reports 95-17, Medicare: Allegations Against ABC Home Health Care, and Waste, fraud, and abuse in the Medicare program : joint hearing before the Subcommittee on Health and Environment and the Subcommittee on Oversight and Investigations of the Committee on Commerce, House of Representatives, One Hundred Fourth Congress, first session, May 16, 1995 (1995) The State of Florida thinks so, too, in it's training on the Florida Baker Act, it's own mental health and commitment law. See www.bakeracttraining.org/files/faq/ba-receiving_facilities.pdf, page 29: "Since negative charting for the purpose of obtaining insurance payments would be inappropriate, one would assume that the insurers aren't aware of Florida law." As does the Journal of Financial Crime. See Brian K. Payne, (2006) "Problems controlling fraud and abuse in the home health care field: Voices of fraud control unit directors", Journal of Financial Crime, Vol. 13 Iss: 1, pp.77 - 91. At least, one would suppose so from Mr. Payne's other publications, such as White-Collar Crime: The Essentials, Brian K. Payne, Sage Publ, Los Angeles, London, etc.; Chap IV Crimes in the Health Care System, p 83: "Types of home health care fraud include providing unnecessary services, billing the system for services that were not provided to the client, overcharging, forgery, negative charting, substitute workers, double billing and kickbacks." Which Mr. Payne held earlier in "Crime in the Home Health Care Field - Workplace Violence, Fraud, and Abuse", Charles C. Thomas Publisher, Ltd., Springfield, IL; 2003. But not the State of Mississippi, which in its Court of Appeals in Whitt v. MMRC, Case No. 95-CA-00946 COA, 8/12/97, it held that, "The difference between negative charting and false charting is that false charting is lying; whereas, negative charting is a form of documentation used by home health care nurses which focuses on the problems of the patient, and not the positive aspects of the patient's health. By focusing on the negative, Medicare payments are assured. ... Negative charting is a widely accepted practice within the profession [home health care]. ... Whitt has not shown that she was asked to falsify records, but merely asked to change the records to reflect proper negative charting, a procedure widely recognized in the home health care industry." It seems that the Oklahoma Attorney General and the Executive Branch do not even make that distinction. When presented with evidence that not only was medical evidence exaggerated in an involuntary commitment to the Tulsa Center for Behavioral Health, but that it was also falsified, the A.G. has responded that no state employee can be sued for the "good faith" performance of their duties. Following complaints sent to the State Department of Health and Board of Osteopathic Examiners, those worthy bodies could find no cause for action. Ain't politics and bigotry grand? I wonder how much it costs the taxpayers."

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