Whistleblowers Claim Community Health Systems Filed False Claims For More Than $450M In Incentive Payments

A pair of former employees have filed suit against Community Health Systems, accusing the national healthcare organization of requesting hundreds of millions in federal incentive payments on false pretenses. CHS, which owns, leases or manages 111 hospitals in 20 states, is one of the largest publicly-traded hospital companies in the U.S.

CHS submitted attestations for incentive payments for several years using an EHR from vendor Medhost, which is also named in the suit. The hospital chain received more than $450 million in such payments between 2012 and 2015.

Though it was supposed to be a federally-certified platform, the Medhost software contained flaws which made it ineligible for certification under the incentive program, the whistleblowers charge. CHS was aware that the attestations it filed for meaningfully using its Medhost EHR software were flawed but pressed ahead with the attestations nonetheless because it needed the revenue they could generate, the suit claims.

Not only that, in the interests of capturing the incentives, CHS implemented the Medhost software so quickly that its implementation generated additional technology problems and even put patients in danger, according to the suit. CHS did this despite warnings from both doctors and hospital administrators, the whistleblowers contend.

For example, problems with the EHR led doctors to order incorrect medications or dosages, made it unable to trigger medications to be delivered at appropriate times, perform drug interaction checks or lock open patient charts, according to a story appearing in Modern Healthcare. “Some of the defects in the software, including an inability to calculate weight-based dosing accurately, exposed patients to mistakes that were easily missed in institutional settings and potentially catastrophic,” the complaint asserts.

On top of all of this, the complaint alleges that the EHR technology used by the 60 hospitals CHS acquired from Health Management Associates didn’t meet certification requirements, and that despite knowing this, CHS filed attestations that it did. (This follows a prior legal black eye In late 2018, in which CHS agreed to pay more than $260 million to the Department of Justice to settle false billing and kickback allegations lodged against HMA.)

This is the third time problems with EHR certification have turned up in the news, and probably not the last.

Just last month, EHR vendor Greenway Health agreed to pay the US Department of Justice a $57 million fine to settle allegations that it falsely obtained its 2014 and 2011 federal certifications. Also, in mid-2017 EHR vendor eClinicalWorks settled a whistleblower suit for $155 million which charged that it had falsely obtained its certification.

You can read Medhost’s response to these allegations here.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

1 Comment

Click here to post a comment