Greenway to pay $57M in False Claims Act settlement with DOJ

A large EHR vendor has agreed to pay $57.25 million to the federal government to settle allegations that the company misrepresented the capabilities of its records software.

The Department of Justice announced the settlement on Wednesday, making it the second high-profile case in as many years involving alleged fraudulent conduct on the part of a major EHR developer.

Also See: Feds fine eClinicalWorks $155M for EHR performance issues

“Electronic health records are critically important to the healthcare decision process, and both patients and providers rely on these technologies to safely and accurately record and transmit vital health information,” said Assistant Attorney General Jody Hunt in DOJ’s Civil Division. “This resolution demonstrates our continued commitment to pursue EHR vendors who misrepresent the capabilities of their products, and our determination to promote public health while holding accountable those who seek to abuse the government’s trust.”

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According to the DOJ, a complaint filed under the False Claims Act alleged that Greenway falsely obtained 2014 Edition certification for its Prime Suite software as a result of concealing from its certifying entity that the product did not fully comply with requirements.

“Among other things, Greenway’s product did not incorporate the standardized clinical terminology necessary to ensure the reciprocal flow of information concerning patients and the accuracy of electronic prescriptions,” states the DOJ announcement. “Greenway accomplished its deception by modifying its test-run software to deceive the company hired to certify Prime Suite into believing that it could use the requisite clinical vocabulary.”

In addition, Greenway was allegedly aware that an earlier version of the product—which was certified to 2011 Edition criteria—did not correctly calculate the percentage of office visits for which its users distributed clinical summaries. As a result, DOJ alleges that certain Prime Suite users falsely attested that they were eligible for EHR incentive payments from the government.

“Greenway refrained from rectifying this error in order to ensure that its users would receive incentive payments,” according to DOJ. “As a result, numerous users of this earlier version of Prime Suite falsely attested that they were eligible for EHR incentive payments when, in fact, they had not met all necessary use requirements. Finally, the government also alleged that Greenway violated the Anti-Kickback Statute by paying money and incentives to its client providers to recommend Prime Suite to prospective new customers.”

At the same time, DOJ’s announcement made it clear that the claims resolved by the settlement are “allegations only” and that “there has been no determination of liability.”

In a written statement, Greenway CEO Richard Atkin pointed out that the settlement with the government is “not an admission of wrongdoing” by the EHR vendor and that all of its products remain certified by the Office of the National Coordinator for Health IT.

“This agreement allows us to focus on innovation while collaborating with our customers to improve the delivery of healthcare and the health of our communities,” added Atkin.

Under the settlement, Greenway has entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services’ Office of Inspector General which—among other provisions—requires the EHR vendor to retain an independent review organization to assess its software quality control and compliance systems, as well as review the company’s arrangements with providers to ensure compliance with the Anti-Kickback Statute.

In addition, among the Corporate Integrity Agreement’s requirements, Greenway must allow Prime Suite customers to: obtain the latest versions of the software at no additional charge; the opportunity to migrate their data to another Greenway-developed product, also at no additional charge; as well as the option of having Greenway transfer their data to another EHR vendor without penalties, service charges or any other fees.

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