“Vendors of electronic health records will be held to the same standards of compliance that we expect of everyone who impacts the delivery of health care services.” Boynton, head of the Department of Justice’s Civil Division. “Electronic health records serve a critical role in informing physician decision making, and it is therefore essential that healthcare providers select such technology free from the influence of improper financial inducements,” said Principal Deputy Assistant Attorney General Brian M. The government’s complaint in intervention alleges that ModMed knew that its EHR did not always allow physician users to electronically record medical records using the required standard vocabularies, thereby causing certain of its users to submit false claims for incentive payments under that program. Eligibility for incentive payments required healthcare providers to use certified EHR technology that, among other things, utilized certain standard vocabularies for drugs (RxNorm) and clinical terminology (SNOMED CT) in order to conduct certain transactions. 2019 Press Release.Īdditionally, under HHS’ EHR Incentive Programs, HHS offered incentive payments to healthcare providers that adopted certified EHR technology and met certain requirements relating to their “meaningful use” of that technology. In January 2019, Miraca (now known as Inform Diagnostics) agreed to pay $63.5 million to resolve allegations that it violated the Anti-Kickback Statute and the Stark Law by providing to referring physicians subsidies for EHR systems and free or discounted technology consulting services. Third, ModMed paid kickbacks to its current healthcare provider customers and to other influential sources in the healthcare industry to recommend ModMed’s EHR and refer potential customers to ModMed.Īs a result of this conduct, the government alleges that ModMed improperly generated sales for itself and for Miraca, while causing healthcare providers to submit false claims for reimbursement to the federal government for pathology services, and for incentive payments from the Department of Health and Human Services (HHS) for the adoption and “meaningful use” of ModMed’s EHR technology. Second, ModMed conspired with Miraca to improperly donate ModMed’s EHR to health care providers in an effort to increase lab orders to Miraca and simultaneously add customers to ModMed’s user base. in exchange for recommending and arranging for ModMed’s users to utilize Miraca’s pathology lab services. In a complaint filed in conjunction with today’s settlement, the United States alleged that ModMed violated the FCA and the Anti-Kickback Statute through three marketing programs: First, ModMed solicited and received kickbacks from Miraca Life Sciences, Inc. The Anti-Kickback Statute prohibits anyone from offering or paying, directly or indirectly, any remuneration - which includes money or any other thing of value - to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs. §§ 3729-3733, by accepting and providing unlawful remuneration in exchange for referrals and causing its users to report inaccurate information in connection with claims for federal incentive payments. (“ModMed”), an electronic health record (“EHR”) technology vendor located in Boca Raton, Florida, has agreed to pay $45 million to resolve allegations that it violated the False Claims Act (FCA), 31 U.S.C.
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