Electronic Health Records Developer To Pay (($57.25 Million To Settle False Claims Act Allegations))

[nitpicker]

https://www.justice.gov/usao-vt/pr/electronic-health-records-developer-pay-second-largest-recovery-history-district-vermont

Department of Justice
U.S. Attorney’s Office
District of Vermont

FOR IMMEDIATE RELEASE
Wednesday, February 6, 2019

Electronic Health Records Developer To Pay Second Largest Recovery In The History Of The District Of Vermont -- $57.25 Million -- To Settle False Claims Act Allegations

The Office of the United States Attorney for the District of Vermont stated today that Greenway Health, LLC (Greenway), a Tampa, Florida-based developer of electronic health records (EHR) software, will pay $57.25 million to resolve False Claims Act allegations that Greenway caused its users to submit false claims to the government by misrepresenting the capabilities of its EHR product “Prime Suite” and providing unlawful remuneration to users to induce them to recommend Prime Suite.
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The American Recovery and Reinvestment Act of 2009 established the Medicare and Medicaid EHR Incentive Program to encourage healthcare providers to adopt and demonstrate their “meaningful use” of EHR technology. Under the program, the U.S. Department of Health and Human Services (HHS) made incentive payments available to eligible healthcare providers that adopt certified EHR technology and met certain requirements relating to their use of the technology. To obtain certification for their product, companies that develop and market EHR technology are required to demonstrate that their product(s) satisfies all applicable HHS-adopted certification criteria. Developers must first pass testing performed by an independent, accredited testing laboratory authorized by HHS, and then obtain and maintain certification by an independent, accredited certification body authorized by HHS.

In its complaint, the government contends that Greenway falsely obtained certification for its product Prime Suite when it concealed from its certifying entity that Prime Suite did not fully comply with the requirements for certification. Among other things, Greenway’s product did not fully incorporate the standardized clinical terminology necessary to ensure the reciprocal flow of information concerning patients and the accuracy of electronic prescriptions. Greenway accomplished its deception by preparing its test-run software to deceive the company hired to certify Prime Suite into believing that it could use the requisite clinical vocabulary.

Additionally, in order to be eligible to receive incentive payments, healthcare providers were required to meet certain targets for EHR-related activities. For example, at certain times providers were required to provide patients with clinical summaries following office visits. In its complaint, the government further alleges that Greenway was aware that an early version of Prime Suite did not correctly calculate the percentage of office visits for which its users distributed clinical summaries and thereby caused certain Prime Suite users to attest falsely that they were eligible for EHR incentive payments. Greenway refrained from rectifying this error in order to ensure that its users would continue to receive incentive payments. As a result, numerous users of this earlier version of Prime Suite falsely attested that they were eligible for EHR incentive payments when, in fact, they had not met all necessary use requirements.

Finally, the government alleged that Greenway violated the Anti-Kickback Statute by paying money and incentives to its client providers to recommend Prime Suite to prospective new customers.
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