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January 28, 2021

Electronic health records vendor athenahealth Inc. will pay $18.25 million to resolve claims brought in two separate whistleblower actions alleging that certain Athena marketing programs provided unlawful remuneration to healthcare providers and others to induce providers to purchase Athena’s EHR systems.  Remuneration to current and prospective customers included all-expenses paid trips to sporting, entertainment, and recreational events, as well as cash payments to customers who referred others to Athena.  In addition, Athena paid other EHR vendors who referred clients to Athena when they were discontinuing their own EHR products and services. The kickbacks allegedly improperly generated sales for Athena while causing healthcare providers to submit false claims to the federal government for incentive payments related to the adoption and “meaningful use” of Athena’s EHR technology. The whistleblowers, Geordie Sanborn, Cheryl Lovell, and William McKusick, will receive a share of the total settlement that remains to be determined.  DOJ; USAO Mass

September 22, 2020

New Jersey biotechnology company Bio-Reference Laboratories, Inc., will pay $11.5 million to resolve two actions brought by whistleblowers alleging that defendant violated the Anti-Kickback statute by paying unlawful remuneration to physicians based on the volume of those doctors’ referrals to defendant.  The remuneration took the form of payments for a percentage of the cost of electronic medical records software used by the doctors.  In addition, defendant was alleged to have unlawfully billed Medicare and Tricare for testing performed on hospital inpatients, instead of billing the hospitals themselves.  USAO SDNY

January 27, 2020

Practice Fusion, Inc., a provider of electronic health records systems, will pay $145 million to resolve criminal and civil charges that it accepted unlawful kickbacks from pharmaceutical companies and misrepresented the capabilities of its EHR software.  As part of the settlement, the defendant entered into a deferred prosecution agreement, paying $26 million in criminal fines and forfeitures, agreeing to compliance policies and monitoring, and admitting that it accepted payment from an unnamed opioid manufacturer in exchange for including "clinical decision support" alerts within its EHR system that were designed to increase prescriptions for the pharma company's drugs.  The civil settlement – $119 million for the federal government and up to an additional $5.2 million for states that choose to opt in – resolves the kickback allegations related to the opioid manufacturer and 13 other such arrangements, as well as allegations that Practice Fusion knowingly misrepresented the capabilities of its EHR system in order to secure federal certification for the software and secure eligibility for federal incentive payments for providers adopting its software.  DOJ; USAO VT

May 31, 2019

A Kansas hospital accused of submitting false claims to Medicare and Medicaid has agreed to pay $250,000 to settle a qui tam suit by Bashar Awad and Cynthia McKerrigan, with about $50,000 of the recovery going to the whistleblowers.  According to the suit, from 2012 to 2013, Coffey Health System falsely attested to having conducted or reviewed security risk analyses of electronic health records (EHR), which was a requirement under a federal incentive program that pays healthcare providers for adopting certified EHR technology.  USAO KS

May 23, 2019

Sixteen states have reached a settlement with the Medical Informatics Engineering and NoMoreClipboard, LLC, which have agreed to pay $900,000 to resolve allegations that the companies violated the Health Insurance Portability and Accountability Act (HIPAA), unfair and deceptive practice laws, notice of data breach statutes, and state personal information protection laws. The companies provide patient portals to healthcare providers, enabling patients to access their health records. Hackers allegedly infiltrated the companies' servers in May 2015, stealing the information of more than 3.9 million individuals. A consent judgment with specific compliance agreements was also entered by the court.  FL; NC

February 6, 2019

An electronic health records provider, Greenway Health LLC, will pay $57.25 million to settle a False Claims Act case brought by the U.S. alleging that Greenway fraudulently obtained certification that is product, Prime Suite, complied with HHS requirements and therefore that healthcare providers using Prime Suite could receive payments under the Medicare and Medicaid EHR Incentive Program.  Greenway allegedly modified the software tested by the certification body to make it appear that Prime Suite was performing as required when it was not, and failed to correct known errors in the software.  In addition, the government alleged that Greenway violated the Anti-Kickback Statute by providing incentives including payments to clients to recommend Prime Suite. Greenway entered into a five-year Corporate Integrity Agreement which includes an independent monitoring process.  DOJ

December 12, 2017

Florida-based 21st Century Oncology Inc. agreed to pay $26 million to settle charges of violating the False Claims Act and the Stark Law through the company’s false attestation to the use of electronic health records software and through referrals from physicians with whom the company had improper financial relationships. DOJ

May 31, 2017

Massachusetts-based eClinicalWorks, one of the country's largest vendors of electronic health records software, along with certain of its employees, agreed to pay $155 million to resolve charges the company violated the False Claims Act by misrepresenting the capabilities of its software.  The company also allegedly paid kickbacks to certain customers in exchange for promoting its product.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Brendan Delaney, a software technician formerly employed by the New York City Division of Health Care Access and Improvement.  He will receive a whistleblower award of roughly $30 million from the proceeds of the government's recovery. DOJ

June 1, 2016

Dr. Jonathan Oppenheimer, former owner and CEO of Nashville drug testing laboratory Prost-Data, Inc. (d/b/a OURLab), OPKO Health, Inc., and OPKO Lab, have agreed to pay $9.35 million to resolve charges they violated the False Claims Act by providing illegal kickbacks in exchange for business.  According to the government, Dr. Oppenheimer and OURLab made donations toward electronic health records (EHR) systems purchased by their client physician practices that fell outside the restrictions set forth in the Anti-Kickback Statute EHR safe harbor and the Stark EHR exception.  The allegations originated in a whistleblower lawsuit filed by a former OURLab employee under the qui tam provisions of the False Claims Act.  The whistleblower will receive a whistleblower award of $1.683 million from the proceeds of the government's recovery.  DOJ (MDTE)

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