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Florida Judge Throws Out False Claims Lawsuit Against Epic


The judge wrote that the complaint "fails the most basic test for particularity.”

A lawsuit filed in Florida against EHR giant Epic Systems has been dismissed by a US District Court judge, who wrote that the “complaint fails the most basic test for particularity” pertaining to the law the plaintiff alleged the company had violated.

The lawsuit hinged on the idea that Epic’s technology enabled the rampant overbilling of Medicare and Medicaid—to the tune of “hundreds of millions of dollars in fraudulent bills for anesthesia services.” The plaintiff was a former compliance staffer at WakeMed Health in North Carolina named Geraldine Petrowski.

Petrowski used Epic’s Resolute Billing Charge Capture System during her employment at WakeMed between 2008 and 2014. In her original filing, she said that she “began to develop major concerns in regard to incorrect billing practices that were driven by [Epic’s] billing software.” Following a 2012 change to federal reimbursement policy that allowed only a physician’s time to be billed for, she said the Epic tech still enabled staff to bill for both time and a base unit of care.

In 2015, she linked with Florid-based law firm Linesch and filed suit in the Tampa Division of the US District Court of the Middle District of Florida. The suit alleged that the company's software could violate (or enable providers to violate) the False Claims Act.

District Judge James S. Moody Jr. was unimpressed with the suit. He noted that Petrowski did not provide evidence that any false claims had actually been submitted by WakeMed Health as a result of Epic’s software, nor did she acknowledge any evidence of other healthcare providers doing so. The allegations simply assert that the Epic software “theoretically” could be used for improper billing, according to the judge.

“In sum, the second amended complaint falls woefully short of stating a claim under the [False Claims Act] and will be dismissed with prejudice,” he wrote in his decision.

When the lawsuit firs became public in 2017, Epic spokesperson Meghan Roh issued a statement saying the Department of Justice had conducted its own review of the case and decided not to move forward, and that the suit “represented a fundamental misunderstanding of how claims software works.” In an emailed statement today, the company repeated that same phrase, and Roh added that Epic was “pleased the court dismissed this case.”

Moody's ruling can be read below:

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