Recent False Claims Act Settlement Reflects Ongoing Focus on EHR Vendor Enforcement

Recent False Claims Act Settlement Reflects Ongoing Focus on EHR Vendor Enforcement

NextGen Healthcare Inc. recently settled with the Department of Justice (“DOJ”), agreeing to pay $31 million over alleged False Claims Act and Anti-Kickback Statute violations. This highlights the DOJ’s continued attention in ensuring healthcare technology companies are compliant with the law, as they become more essential in-patient care.

The allegations against NextGen’s EHR system relate to the CMS EHR Incentive Program. NextGen supposedly obtained false certification for its software and violated the Anti-Kickback Statute by providing incentives to customers who referred to new sales.

EHRs refer to electronic health records which differ from EMR’s electronic medical records.  Electronic medical records (EMRs) are a digital version of the paper charts which contain the medical and treatment history of the patients in one practice.

Electronic health records focus on the total health of the patient and are built to accumulate records that go beyond the digitization of the individual office.  They are configured to share information with other health care providers, such as laboratories and hospitals.

Jason T. Brown, head of the whistleblower law firm Brown, LLC, emphasized, “These cases underscore the necessity for EHR vendors and EMR vendors to make sure they’re complying with what’s best for the patient, not just for their profits.  If the product is configured to enable Medicare fraud, then there will be accountability and kickbacks are a big no-no.”

This settlement is part of a series of similar actions against EHR vendors. In prior cases, vendors settled for violations involving software performance, fraud during certification, or kickback schemes.

As the healthcare industry relies more on technology, vendors and providers receiving incentive payments must be aware of potential compliance issues. The government’s enforcement efforts underscore the need for vigilance and legal guidance and for EHR whistleblowers and EMR whistleblower to come forward.