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eClinicalWorks fraud settlement bad for co-conspirators ? but likely not for users

Physician Practice Insider, June 12, 2017

A fraud settlement by a major electronic health record (EHR) vendor with the Department of Justice (DOJ) has some providers spooked, but it’s unlikely that providers that use that system will lose incentive program money because of the malfeasance of vendors – assuming the providers are innocent.

eClinicalWorks (ECW) and some of its employees would pay $155 million to settle false claims act allegations, DOJ announced May 31.

The original whistleblower suit alleged “ECW falsely represented to its certifying bodies and the United States that its software complied with the requirements for certification and for the payment of incentives under the meaningful use program.” That is, ECW “prepared its software in order to pass certification testing without meeting the certification criteria; and … caused its users to report inaccurate information regarding meaningful use objectives and measures in attestations” to CMS.

For example, in the ePrescribing part of its EHR certification test for 2014, ECW “identified the 16 drugs for which ECW would need to generate a prescription during testing” rather than set up its system to retrieve whatever drug would be needed, the complaint alleged. “ECW then ‘hardcoded’ into its testing software only the 16 [drug] codes it knew in advance that its certification body would test.” The company allegedly did that again the following year.

The settlement also charged that “ECW paid kickbacks to certain customers in exchange for promoting its product,” in violation of the anti-kickback statute. Under the settlement, along with the money, eClinicalWorks has to help and pay for clients to transfer their data to new systems if they choose.

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