DoJ Joins False Claims Whistleblower Suit Against EHR Vendor Modernizing Medicine

The US Department of Justice has announced that it intends to join a whistleblower lawsuit filed against EHR vendor Modernizing Medicine and cofounder and CEO Daniel Cane. The suit alleges that the company engaged in serious violations of the False Claims Act and illegal kickbacks to physicians.

The whistleblower in the case is Amanda Long, who joined the company in 2014 and exited her role as vice president of product management in 2017.

Modernizing Medicine sells a cloud-based EHR system to specialty practices, including gastroenterology, orthopedics, ophthalmology, otolaryngology, pain management, plastic surgery, rheumatology, urology and dermatology practices.

A law firm filed the whistleblower complaint under seal in 2017 on behalf of a former company executive. However, the case went public in late March when a federal district court in Vermont remove the seal. The DoJ intervened in mid-March and expects to file its own complaint against the vendor in the next 90 days or so, according to an agency press release.

The whistleblower suit asserts that millions of dollars in false claims were submitted to HHS. This included requests for both federal incentive payments and claims reimbursement submitted to federal insurance programs such as Medicare, Medicaid, and Tricare.

The suit claims that Modernizing Medicine falsely told certifying bodies and the US that its software met the requirements for certification and incentive payments under the meaningful use program. This in turn caused users to falsely claim that they were using a certified EHR and to report inaccurate information regarding meeting meaningful use measures in their attestations to CMS, it contends.

According to the complaint, the flaws in Modernizing Medicine’s EHR not only made the system unreliable and unable to meet meaningful use standards but also created patient safety risks. Instead of fixing these problems, the company “continuously de-prioritized high-priority defects in favor of the development of new products and new sources of revenue.”

Flaws that could have had an impact on patient safety included inaccurate ePrescribing of medications, inaccurately recording medical history, date and time of encounter note entries, and inaccurate association of lab results with orders.

Not only that, the complaint alleged that Modernizing Medicine paid out illegal payoffs or kickbacks to certain individuals, in forms that included giving those individuals exclusive access to an enhanced interface, a prescription prior authorization program, an e-couponing program, a referral program, and a reference program.

While the meaningful use era may be over, allegations of bad behavior related to the program continue to surface.

For example, last year the DoJ came down on CareCloud Health, which agreed to pay $3.8 million to settle allegations that it paid out illegal kickbacks to generate sales.

In early 2020, Practice Fusion agreed to pay $145 million to settle allegations that it paid out kickbacks to increase opioid prescriptions and had issues with its meaningful use EHR certification.

Go back to 2017 and you’ll find the news that eClinicalWorks settled civil fraud and kickback charges with the government for $155 million.

I suppose it was inevitable that with such tempting opportunities available to vendors of certified EHR technology, some would end up cutting corners. However, it’s disappointing to think that Modernizing Medicine might have let problems go that could have caused patients real harm.

About the author

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.

   

Categories