EHR Vendor Pays $57.2M to Settle False Claims, Anti-Kickback Allegations

Prosecutors allege that Greenway Health lied about the meaningful use certification of its Prime Suite electronic health records software.

Greenway Health LLC will pay $57.2 million to resolve False Claims Act allegations involving deceptive claims about the vendor's Prime Suite electronic health records software, the Department of Justice announced Wednesday.  

In its complaint, federal prosecutors said Greenway falsely obtained 2014 Edition certification for Prime Suite, even as the vendor concealed from its certifying entity that Prime Suite did not fully comply with the requirements for certification.

Among its shortcomings, prosecutors allege that Prime Suite did not incorporate the standardized clinical terminology necessary to ensure the reciprocal flow of information concerning patients and the accuracy of electronic prescriptions.

According to DOJ, "Greenway accomplished its deception by modifying its test-run software to deceive the company hired to certify Prime Suite into believing that it could use the requisite clinical vocabulary." 

As a result of the alleged deception, DOJ said Greenway's Prime Suite users unknowingly submitted false claims to Medicare and other government healthcare programs using software that misrepresented their meaningful use capabilities.  

Assistant U.S. Attorney General Jody Hunt of the Department of Justice's Civil Division said the 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."

Federal prosecutors also alleged that Greenway was aware that a 2011 edition of its Prime Suite software did not correctly calculate the percentage of office visits for which its users distributed clinical summaries. As a result, some Prime Suite users unknowingly but incorrectly claimed that they were eligible for EHR incentive payments. 

Lastly, prosecutors alleged that that Greenway violated the Anti-Kickback Statute by paying money and incentives to its client providers to recommend Prime Suite to prospective new customers.

U.S. Attorney for the District of Vermont Christina E. Nolan, a co-prosecutor in the Greenway settlement, noted that her office has prosecuted two cases against EHR vendors and recovered more than $212 million.

"These cases are important, not only to prevent theft of taxpayer dollars, but to ensure that the promise of health technology is realized in the form of improved patient safety and efficient healthcare information flow," Nolan said.

In a media release, 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," Atkin said.

Greenway also entered into a five-year Corporate Integrity Agreement with the HHS Office of Inspector General that will require Greenway to retain an independent auditor to assess Greenway's software quality control and compliance, and to review Greenway's arrangements with providers to ensure compliance with the Anti-Kickback Statute.

The CIA also requires Greenway to give Prime Suite customers: An updated versions of Prime Suite for free; or the opportunity to switch to other Greenway software, also for free; or the option to transfer their data to another EHR vendor with no fees beyond money owed for goods or services already provided.