This story was updated Wednesday evening.
[V]ermont federal prosecutors have reached a $57.25 million settlement with a Florida-based electronic health records software company over claims the firm caused medical providers nationwide to submit false claims to the government and provided kickbacks to users.
The civil settlement with Greenway Health LLC of Tampa, Florida, was announced at a Wednesday afternoon press conference by U.S. Attorney for Vermont Christina Nolan.
Nolan called it the second largest civil settlement in the district of Vermont’s history, trailing only one announced in May 2017 also involving an electronic health records software company, eClinicalWorks, which settled for $155 million.
In the latest settlement, Greenway will pay $57.25 million to the U.S. Department of Health and Human Services. Nolan said that represents more than double the $28 million in alleged false claims the firm caused to be paid out by the federal government.
As part of the settlement, Greenway does not admit or deny wrongdoing, and federal prosecutors will not pursue criminal charges against the company.
“I want to underscore just how serious this conduct is — it involves false claims against the Medicare fund, taxpayer dollars we can ill-afford to lose,” Nolan said.
“Like (eClinicalWorks), Greenway stole millions from that fund,” she added. “It secured the payout of federal funds designed to improve patient care by deceptively obtaining certification for software that created risks to patient safety, risks in the form of inaccurate prescription ordering and doctors denied access to patients’ medical histories.”
Nolan said the U.S. attorney’s office in Vermont handled the nationwide case, in large part, because of expertise it has developed in its staff to investigate such cases.
“This is the new frontier of health care fraud,” the prosecutor said.
According to Nolan, Greenway falsely obtained certification for its electronic health records software, Prime Suite, concealing from the certifying entity that it did not fully meet requirements for certification.
“We allege,” the prosecutor said, “that Greenway reviewed in advance the test that would be administered for certification of the software, that it manipulated the software so that it would pass the test, thereby deceiving its testing body into believing that Prime Suite, the EHR software, met all of the HHS requirements.”
Health care providers, who are eligible to receive incentive payments from the federal government by meeting certain electronic health records targets, then received those payments even though the Power Suite software they were using did not properly meet standards.
“Greenway refrained from rectifying this error in order to ensure that its users would continue to be eligible for EHR incentive payments,” a statement from the prosecutor’s office read.
“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 the necessary use requirements.”
Federal prosecutors also said Greenway violated the Anti-Kickback Statute by paying a total of about $750,000 in money and incentives to its users to recommend Prime Suite to new customers.
Nolan would not comment at the press conference which Vermont medical providers may have received kickbacks from Greenway, other than to say that there were some medical providers in the state that use the firm’s software.
“I don’t have a list of names for you,” she said, adding, “Whether those doctors knew they were kickbacks, we’re not commenting or alleging.”
Greenway Health is a privately held company with about 1,500 employees.
“The settlement is not an admission of wrongdoing by Greenway, and all our products remain ONC-certified,” Richard Atkin, CEO of Greenway Health, said in a statement Wednesday afternoon. ONC refers to the Office of the National Coordinator for Health Information Technology.
“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.”
Asked if prosecutors knew of any specific injury a patient may have suffered as a result of the software issue, Nolan said at the Wednesday press conference, “We don’t allege any harm to any specific patients in this complaint.”
In addition to the $57.25 million monetary payment, the settlement calls for Greenway Health to enter a five-year corporate integrity agreement with the federal government. That agreement requires the firm retain an independent software oversight company to assess quality and controls, providing regular reports.
The company must also notify its customers of the software issues and provide free updated software or pay for customers to transfer their records to another vendor.
