EHR Vendor to Pay $57 Million to Settle FCA Case

February 11, 2019 | Geoffrey R. Kaiser | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid

On February 6, the U.S. Department of Justice announced that Greenway Health LLC, a Florida-based developer of electronic health records (EHR) software, will pay $57.25 million as part of a False Claims Act settlement. The United States had alleged that Greenway misrepresented the capabilities of its software product, called “Prime Suite,” causing healthcare providers to submit false claims to the government for EHR incentive payments.

Specifically, the government alleged that Greenway obtained false certification for its software by concealing from the certifying entity that Prime Suite did not fully comply with requirements that the software incorporate standardized clinical terminology needed to ensure proper information flow concerning patients and the accuracy of electronic prescriptions. Additionally, the government alleged that Greenway knowingly failed to correct a flaw in an early version of the Prime Suite software that caused its provider users to falsely attest that they were eligible for EHR incentive payments. The government also alleged that Greenway violated the federal Anti-Kickback Statute (AKS) by paying money and incentives to its client providers to recommend Prime Suite to prospective new customers.

As part of the settlement, Greenway entered into an innovative Corporate Integrity Agreement (CIA) with the Office of Inspector General of the U.S. Department of Health and Human Services (OIG). The CIA requires, among other things, that Greenway retain an Independent Review Organization to evaluate Greenway’s software quality control and compliance systems and to review its arrangements with providers to ensure compliance with the AKS. The CIA further requires that Greenway provide notice to customers of any potential patient safety issues; allow customers to obtain the latest versions of the software at no charge; afford providers the opportunity to migrate their data from Prime Suite to an alternative Greenway product at no charge; and give customers the option to have Greenway transfer their data to another EHR software vendor at no charge (other than any contractual amounts still owed for goods or services already provided).

The case was jointly handled by the Civil Division, Commercial Litigation Branch and the U.S. Attorney’s Offices for the District of Vermont and the Northern District of Georgia, assisted by OIG and the Federal Bureau of Investigation.

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