EHR vendor Greenway Health has agreed to pay the US Department of Justice a $57.25 million fine to settle allegations that it falsely obtained its 2014 and 2011 federal certifications and violated federal law by paying providers for sales leads.
In its complaint, the Department of Justice asserted that Greenway deceptively obtained a 2014 Edition EHR certification for its Prime Suite product, having hidden the fact that its product didn’t fully comply with certification requirements.
According to the federal complaint, Prime Suite didn’t incorporate the standardized clinical terminology needed to enable reciprocal flow of information concerning patients as well as the accuracy of e-prescriptions. To hide this deficiency, the DoJ said, Greenway modified its test-run software to trick the company it hired to certify the product.
In addition, the government claimed, Greenway was aware that an earlier version of Prime Suite certified for 2011 Edition criteria didn’t correctly calculate the percentage of office visits for which its provider customers gave patients with clinical summaries, which led some Prime Suite users to incorrectly attest they were eligible for EHR incentive payments. The complaint contends that Greenway decided not to fix the error, as some of its customers wouldn’t have gotten the incentive payment they were expecting.
The government also claimed that the vendor had violated the Anti-Kickback Statute by paying its client providers money and incentives to recommend Prime Suite to potential new customers.
As part of the settlement, Greenway agreed to enter into a five-year Corporate Integrity Agreement with the HHS Office of Inspector General. The agreement requires, among other things, that the company retain an Independent Review Organization to watch over Greenway’s software quality control and its compliance systems. The IRO will also oversee the company’s arrangements with healthcare providers to make sure that the vendor doesn’t violate the Anti-Kickback Statute.
Meanwhile, Greenway must allow its Prime Suite customers to obtain the latest versions of the product at no additional charge, migrate the data from Prime Suite to another Greenway-developed software product at no additional charge and allow Prime Suite customers the option to transfer their data to another EHR vendor without incurring additional fees.
Less than two years ago, eClinicalWorks was at a similar juncture, agreeing to settle a whistleblower suit filed against the Department of Justice for $155 million.
In its action against eCW, which was settled May 2017, the government argued that the vendor had falsely obtained certification for its EHR software, having doctored its product to hide the fact that it didn’t meet certification requirements such as including standardized drug codes, performing drug interaction checks, recording diagnostic imaging orders and meeting data portability requirements.