Phillips & Cohen partner Colette Matzzie writes in HIStalk about the key lessons and trends since Phillips & Cohen’s ground-breaking whistleblower lawsuit against electronic health records vendor eClinicalWorks, which settled for $155 million in 2017.
The June 2017 announcement by the Department of Justice of a $155 million settlement with eClinicalWorks for alleged misrepresentation of the capabilities of its electronic medical record software heralded the start of a new area for health fraud enforcement. Both DOJ and the HHS – Office of Inspector General announced that investigations of alleged fraud involving electronic health records systems would be a top enforcement priority. Enforcement has continued at a steady clip, with DOJ bringing actions against six additional electronic health records vendors. There is every reason to think more will be forthcoming.
Most actions have been initiated by whistleblowers using the False Claims Act, but, at least two actions, including one resulting in a $145 million settlement, were initiated by the government.
Five lessons can be drawn from this period of robust enforcement.
DOJ and HHS-OIG have made good on their promise to investigate allegations of fraud in the development and implementation of electronic health records.
Since June 2017, five settlements and one additional intervention have been announced:
- February 2019 settlement with Greenway for $57.25 million.
- January 2020 settlement with Practice Fusion for $145 million.
- August 2020 settlement with Konica Minolta for $500,000.
- January 2021 settlement with Athenahealth for $18.25 million.
- April 2021 settlement with CareCloud for $3.8 million.
- March 2022 intervention in a pending qui tam against Modernizing Medicine.