Alleged Meaningful Use Fraud Results in EHR Vendor Settlement
DOJ Settlement with eClinicalWorks
In May 2017, Electronic Health Record (“EHR”) vendor eClinicalWorks settled allegations of False Claims Act and anti-kickback statute violations with the United States Department of Justice for $155 million. The government alleged that the company had misrepresented the capabilities of its software in order to be certified EHR technology (“CEHRT”) required for the Centers for Medicare and Medicaid Services (“CMS”) Meaningful Use program.
In response to the development of the Meaningful Use program, EHR vendors redesigned certain elements of their software to meet the Meaningful User certification criteria. EHR vendors then had to prove to certifying bodies that the products were capable of performing the required Meaningful Use objectives. The certifying bodies published testing criteria in advance of the actual tests so that the EHR vendors could prepare for the certification test. The government alleged that eClinicalWorks falsified its EHR’s capabilities. eClinicalWorks was accused of using the published testing criteria to hardcode electronic prescription codes that it knew would be tested. The government’s complaint listed a variety of other allegations against eClinicalWorks, including that its software did not meet the required audit criteria and that it did not reliably run drug interaction checks, among other things.
Many providers using eClinicalWorks attested to Meaningful Use and received incentive payments. The government claimed that eClinicalWorks knew that its software did not meet the certifying requirements, and this caused the submission of false claims by the providers who used eClinicalWorks to attest to Meaningful Use.
What Does This Mean for Providers?
Providers who purchased and used eClinicalWorks to achieve and attest to Meaningful Use should not be targeted due to eClinicalWorks’ misconduct. After the DOJ settlement was announced, CMS published an FAQ on the subject. CMS stated it “does not plan to conduct an audit to find providers who relied on flawed software for their attestation information.” It went on to say that CMS “believe[s] that most providers who were improperly deemed meaningful users would have met the requirements of the EHR Incentive Program using updated certified EHR technology.”