The US Department of Justice announced this week that the US Department of Justice has agreed to pay $45 million to settle allegations that the company violated the False Claims Act.
WHY IT IMPORTANT
The Justice Department alleges that ModMed accepted and provided “illegal remuneration in exchange for referrals and by causing its users to report inaccurate information regarding incentive payment requests.” federal incentives.”
As U.S. Attorney for the Vermont District Nikolas P. Kerest explained in a statement, “the government alleges that over the years, ModMed, through multiple schemes, has engaged in illegal kickbacks that distort This resolution reflects both the EMR and pathology lab markets and provides users with a product in short supply.This resolution reflects the seriousness of the government’s allegations and the Department of Justice’s determination to restore integrity to the field of electronic health records.”
The DOJ alleges that ModMed violated the FCA and the Anti-Return Regulation through three marketing programs:
- The company allegedly solicited and received money back from Miraca Life Sciences in exchange for referring and arranging for ModMed users to use Miraca’s pathology laboratory services.
- The complaint also alleges that ModMed conspired with Miraca to “improperly donate ModMed’s EHRs to healthcare providers in an attempt to increase lab orders for Miraca and at the same time add customers.” into ModMed’s user base.”
- The DOJ claims the company paid kickbacks to its supplier customers and others for referring its EHR and referring potential customers to ModMed.
The government alleges that this practice allowed ModMed to “inappropriately generate sales for itself and for Miraca, and to cause healthcare providers to submit claims for federal government for medical services and incentive payments from the Department of Health and Human Services for adoption and ‘meaningful use’ of ModMed’s EHR technology.”
The settlement partially addresses the allegations in the lawsuit filed by Amanda Long, the former vice president of product management at ModMed, the DOJ noted. Given that the lawsuit was filed under the FCA’s whistleblower provisions, which allow individuals to sue on behalf of the government and share in any recovery, Long will receive approximately $9 million.
TREND TO BIGGER WOMAN
In January 2019, Miraca – now known as Inform Diagnostics – paid $63.5 million to settle allegations that it violated the Anti-Background Act and Stark Law by providing subsidies to doctor for free or discounted EHR system and technology consulting services.
Since the DOJ promised 5 years ago that it would be on the lookout for more possible false claims violations by EHR providers – it has recovered $3.7 billion from lawsuits False Claims Act of 2017, including from major vendors like eClinicalWorks – the department has continued to yield some significant monetary payments, including $57 million paid out by Greenway in 2019 .
“EHR companies should weigh themselves on notice,” a US Attorney said after that 2019 finding.
More recently, CareCloud paid $3.8 million to the DOJ in 2021, to resolve kickback allegations for its marketing referral program.
ON PROFILE
“Today’s agreement marks the fourth resolution our office has reached as we seek to root out fraud in electronic health record technology,” Kerest said. “It is imperative that healthcare providers trust the health record systems in which they record important and sensitive patient information, and e-health record providers have long been only prioritizing sales.”
“Electronic health records play an important role in informing physician decision-making, and it is therefore essential that healthcare providers choose such technology. without being influenced by improper financial motives,” Deputy Assistant Attorney General Brian M. Boynton added in a statement. “Electronic health record providers will be subject to the same standards of compliance that we expect from all healthcare providers.”
Twitter: @MikeMiliardHITN
Email the writer: [email protected]
Healthcare IT News is a HIMSS publication.
