The U.S. Department of Justice claims the EHR vendor provided unlawful payment to users to recommend its system.
Greenway Health, a developer of electronic health records (EHRs) in Tampa, Fla., will pay $57.25 million to resolve allegations in a complaint filed by the U.S. under the False Claims Act, according to the U.S. Department of Justice.
The complaint claimed that Greenway caused its users to submit false claims to the government by misrepresenting what its EHR product called “Prime Suite” can do. It also claimed that Greenway provided unlawful payments to users to get them to recommend Prime Suite to others.
When the Medicare and Medicaid EHR Incentive Program was established in 2009 to encourage healthcare providers to adopt and demonstrate their meaningful use of the technology, the U.S. Department of Health and Human Services (HHS) made incentive payments eligible to providers that adopted certified EHR technology and met certain requirements related to the use of the systems.
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According to the Justice Department, Greenway falsely obtained certification in 2014 for Prime Suite after hiding that the system did not fully comply with certification requirements. Prime Suite also did not use the standardized clinical terminology that was necessary to ensure the flow of information from patients and the accuracy of electronic prescriptions.
Greenway was able modify its test-run software to deceive the company that was hired to certify Prime Suite into believing it used the proper clinical terms.
The government also claimed that Greenway knew that an earlier version of its system that was certified in 2011 did not correctly calculate the percentage of office visits that its users distributed clinical summaries for. This caused users to falsely claim that they were eligible to receive EHR incentive payments. Greenway did not fix this error — so that its users would receive the payments — despite not meeting all of the necessary use requirements.
Additionally, there were claims that Greenway violated the Anti-Kickback Statute — that prohibits payment for referrals for services that are payable by a federal program — by paying money and incentives to its providers to recommend Prime Suite to potential new customers.
Christina E. Nolan, U.S. Attorney for the District of Vermont, said that in the last two years, her office has resolved two fraudulent conduct issues against leading EHR developers, resulting in the two largest recoveries in the history of the district and represent the return of over $212 million dollar of fraudulently-obtained taxpayer money.
“These cases are important, not only to prevent theft of taxpayer dollars, but to ensure that the promise of health technology is realized in the form of improved patient safety and efficient healthcare information flow,” Nolan.
Per the settlement, Greenway has entered into a five-year Corporate Integrity Agreement with the HHS Office of Inspector General covering the company’s EHR software.
Among the many requirements, the agreement requires that Greenway retains an Independent Review Organization to assess its software quality control and compliance systems and to review the company’s arrangements with healthcare providers to ensure compliance with the Anti-Kickback Statute.
“This resolution demonstrates our continued commitment to pursue EHR vendors who misrepresent the capabilities of their products, and our determination to promote public health while holding accountable to those who seek to abuse the government’s trust,” said Jody Hunt, Assistant Attorney General of the Department of Justice’s Civil Division.
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