Consumer Fraud

eClinicalWorks Settlement is ‘New Area of Health care Fraud’

Pills Stethascope on Money 435x289 eClinicalWorks Settlement is New Area of Health care FraudElectronic health record vendors have fallen under greater regulatory scrutiny following the resolution of a whistleblower’s False Claims Act lawsuit that exposed some dirty secrets within the electronic health records (EHR) industry.

Last month, eClinicalWorks, one of the nation’s largest vendors of EHR software, agreed to pay the U.S. $155 million to settle allegations that it misrepresented its software’s capabilities and falsely obtained government-required certification for it.

According to the whistleblower suit, eClinicalWorks hid its software’s noncompliance with federal certification requirements from the certifying agency. As a result, the company’s EHR software failed to perform a multitude of functions that hospitals and other health care providers needed to be compliant with Medicare and Medicaid rules.

Now the federal government wants to send a message to other software developers who might be inclined to use similar tricks.

In a video made by the U.S. Justice Department’s Office of Inspector General (OIG), the agency’s senior counsel John O’Brien indicates the government will widen its probe of EHR developers.

“We’re entering an entirely new area of health care fraud,” Mr. O’Brien said.

“OIG will vigilantly, along with law enforcement partners, investigate any conduct that places patient safety at risk and that causes losses to the federal health care programs,” Mr. O’Brien says in the video, which was posted to YouTube. “We take the certification process for EHR software very seriously. There is no room for manipulating this process and making false statements during certification.”

He said that the noncompliant software also puts patients at risk:

“It’s very critical, just like in the written, the old medical records, that everything be accurate,” Mr. O’Brien said. “If there are any defects in EHR software program, then critical tests and medical prescriptions may not be accurately processed and that could have detrimental effects on patient care.”