Community Health Systems is currently under civil investigation over EHR adoption and compliance to government standards that regulate incentive payments under the federal Meaningful Use program.
The disclosure came deep within a dense financial filing Wednesday, first reported by FierceHealthcare. Although it's unclear whether the civil investigative demand was filed by a state attorney general's office or from federal investigators at the Justice Department or Office of Inspector General, CHS indicated it is responding to subpoenas and other demands.
CHS, one of the country's largest for-profit health systems, uses three EHR networks across its 118 hospitals: Cerner, Medhost and an in-house system from Health Management Associates (HMA), a 70-hospital organization CHS acquired in 2014.
EHR incentive payments have increasingly found themselves under the microscope of federal investigators in the past year or so. The scrutiny stems in part from the 2017 eClinicalWorks controversy in which the EHR company paid out $155 million to DOJ following whistleblower allegations that it knowingly caused providers to submit fraudulent EHR incentive payments.
At the time, EHR vendors and legal experts forecast that the settlement would be the start of greater DOJ activity in the field, and recent months have seen those predictions realized. EClinicalWorks, actually, was fined $132,500 in July by the OIG for violating the corporate integrity agreement birthed in that initial settlement.
In November, people working on behalf of the estate of a man who died of cancer filed a $1 billion lawsuit against eClinicalWorks alleging the company's faulty software contributed to the progress of the disease. The suit also claimed that millions of patients were affected because the company's software didn't meet Meaningful Use certification requirements.
Through the Meaningful Use program, the government distributed more than $38 billion to providers to install EHR systems.
But OIG reported that last year alone federal investigators issued $729 million in inappropriate incentive payments. CMS agreed to pursue a small part of the payments highlighted by auditors. OIG is currently conducting a second review of Medicare EHR incentive payments, which it plans to publish later this year.
According to annual financial filings analyzed by Fierce Healthcare, CHS received more than $865 million in EHR incentive payments between 2011 and 2017 through the Health Information Technology for Economic and Clinical Health Act enacted in 2009.
According to the filing from CHS, management does "not believe that loss contingencies arising from pending legal, regulatory and governmental matters, including the matters described herein, will have a material adverse effect on the consolidated financial position or liquidity" of the company.
The assertion comes on the heels of a strong Q2 earnings report for the Franklin, Tennessee-based provider.
Though CHS and Cerner did not respond to a request for comment, Medhost representative Samra Khan said in an email to Healthcare Dive "it is MEDHOST's policy to not make specific comments regarding customer matters."