- Tampa, Florida-based Greenway Health has agreed to pay the U.S. Justice of Department $57.25 million to settle allegations the vendor caused users to submit false claims to the EHR Incentives Program.
- The government claimed Greenway misrepresented the capabilities of its Prime Suite EHR to customers and paid users to recommend the product to potential buyers.
- The complaint further alleged Greenway falsely obtained 2014 Edition certification status for Prime Suite by hiding the fact that it failed to meet certification requirements from the certifying entity.
The case is the second False Claims Act lawsuit involving an EHR vendor in the past two years. In 2017, eClinical Works paid the government $155 million to settle allegations around misrepresentation of software capabilities and $392,000 in kickbacks to customers who promoted its product.
The False Claims Act is increasingly relied upon to resolve attempts to defraud Medicare and Medicaid. Last month, DOJ slapped Walgreens with a $270 million fine to settle two lawsuits accusing the pharmacy giant of improperly billing Medicare and Medicaid for drug reimbursements. The cases, covering improper practices over a 10-year period, stemmed from whistleblower complaints under the False Claims Act.
According to DOJ, Greenway's Prime Suite software failed to meet 2014 Edition specifications on standardized clinical terminology required to ensure proper transmission of patient information and electronic prescriptions. Greenway concealed the problem by modifying its test-run software to indicate the EHR could use the clinical vocabulary, DOJ says.
In addition, Greenway allegedly knew that an earlier version of Prime Suite, which was certified to 2011 Edition criteria, miscalculated the share of office visits for which users distributed clinical summaries, causing some users to falsely claim they were eligible for EHR incentive payments. Greenway covered up the issue to ensure users received the payments, DOJ says.
"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," Jody Hunt, assistant attorney general for DOJ's Civil Division, said in a press release announcing the settlement.
The settlement includes a five-year Corporate Integrity Agreement requiring Greenway to retain an outside entity to assess the quality control and compliance systems associated with its EHR software and to ensure arrangements between the vendor and customers don't violate the Anti-Kickback Statute.
Greenway must also alert customers to any patient safety issues and maintain a list of any issues and related mitigation measures on its customer portal. And customers must be able to acquire the latest version of Prime Suite and migrate data from Prime Suite to other Greenway software at no additional charge. Greenway is also barred from penalizing customers that choose to transfer their data to another EHR software vendor.
In a statement, Greenway Health CEO Richard Atkin said, "The settlement is not an admission of wrongdoing by Greenway, and all our products remain ONC-certified. 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."
The case was jointly handled by the Civil Division's Commercial Litigation Branch, the U.S. attorney's offices for the District of Vermont and the Northern District of Georgia and the HHS Office of Inspector General.