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Electronic Health Records

This archive displays posts tagged as relevant to electronic health records and fraud related to electronic health records.

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DOJ Discusses Its 2020 Healthcare Fraud Enforcement Priorities

Posted  03/6/20
DOJ Headquarters building seen from low angle
In comments at the 2020 FBA Qui Tam conference, the Department of Justice reaffirmed its strong commitment to pursuing fraud under the False Claims Act and emphasized its particular focus on rooting out healthcare fraud. Jody Hunt, Assistant Attorney General in the Civil Division of DOJ, was encouragingly forceful in his comments about the critical role of the FCA in protecting the public fisc—and the patient...

Catch of the Week: Practice Fusion Pays $145 Million for EHR Kickbacks and Misrepresentations about Software

Posted  01/28/20
Healthcare providers talk about the importance of behavioral “nudges” – gentle pushes to encourage healthy choices and positive behaviors. In our Catch of the Week, healthcare providers were nudged to prescribe highly addictive extended-release opioids in a manner that was not consistent with accepted medical standards. Who nudged them? Their own electronic health records system, which was paid to do so by the...

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

Top Ten Healthcare Fraud Recoveries of 2019

Posted  01/24/20
Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2019 stemmed from healthcare fraud matters.  And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act.  Not surprisingly, seven of the top ten spots in our list involved false claims act lawsuits against drug companies...

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

Catch of the Week – EHR Developer Greenway Health to Pay $57.25 Million to Settle FCA Allegations

Posted  02/8/19
Person in scrubs holding computer tablet projecting medical data
Electronic health records (EHR) software developer Greenway Health LLC agreed to pay $57.25 million to resolve allegations that it committed fraud by misrepresenting to its users the capabilities of its EHR product “Prime Suite” and by providing unlawful remuneration to users to induce them to recommend Prime Suite. Under the American Recovery and Reinvestment Act of 2009, the government made incentive payments...

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

Catch of the Week – Inform Diagnostics

Posted  02/1/19
Technician in laboratory safety wear using eyedropper to fill vials of blood
Texas-based pathology laboratory company Inform Diagnostics, formerly known as Miraca Life Sciences Inc., agreed on January 30th to a $63.5 million settlement to resolve allegations it violated the False Claims Act (“FCA”), the Anti-Kickback Statute (“AKS”), and the Stark Law by providing subsidies to referring physicians for electronic health record (“EHR”) technology as well as free or discounted...

Following $155M FCA Settlement, EHR Provider Hit with Class Action Suit

Posted  01/4/18
By the C|C Whistleblower Lawyer Team Last May, eClinicalWorks (ECW) resolved allegations that it misrepresented the capabilities of its software when the EHR has being tested for CMS certification. Healthcare providers that use CMS-certified EHR software qualify for incentive payments from the agency. Instead of developing software that met the relevant requirements, ECW allegedly designed software to pass the...
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