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EHR Vendor Agrees to Pay $57 Million to Resolve Alleged Violations of the False Claims Act and Anti-Kickback Statute

Last month, the United States Department of Justice (DOJ) announced that Greenway Health, an electronic health records (EHR) software vendor, had agreed to pay close to $57 million to settle allegations that the company caused its customers to submit false claims to Medicare and Medicaid in violation of the federal False Claims Act (FCA). The settlement also resolves allegations that Greenway Health violated the Anti-Kickback Statute (AKS) by illegally paying some of its customers for recommending the company’s products to potential new customers.

The FCA allegations concern the Meaningful Use programs under Medicare and Medicaid, whereby healthcare providers can receive incentive payments for demonstrating their adoption and use of EHR software for documenting patient care. In order to qualify for these incentive payments, providers must implement software that is deemed “Certified EHR Technology” (CEHRT) by the Office of the National Coordinator of HIT (ONC). The DOJ alleged that Greenway Health made material false statements to ONC about its software and concealed deficiencies by programing “shortcuts” that made the software appear to pass ONC’s functionality standards for CEHRT. Thus, Greenway Health allegedly falsely obtained CEHRT status for its software products, which resulted in healthcare providers seeking incentive payments under the Meaningful Use programs on the mistaken belief that implementing Greenway Health’s software qualified such providers for the incentive payments.

The allegations in this case are very similar to the facts involved with eClinical Works’ (eCW) settlement with the DOJ in May 2017. In that case, eCW agreed to pay $155 million to resolve allegations that it violated the FCA when it similarly obtained CEHRT status for its software after providing fraudulent information to ONC.