OIG counsel: watch your steps, EHR vendors

by Roy Edroso on Aug 1, 2017


Some video commentary from OIG on a recent eClinicalWorks false claims settlement indicates the agency is interested in looking at other EHR software vendors for signs that they cut corners to meet standards.

You may recall that eClinicalWorks (eCW) settled a whistleblower suit in May that alleged it had prepared its EHR software to pass certification testing but not necessarily to actually perform in the field up to standards set by CMS and the Office of the National Coordinator (ONC) for certified EHR technology (CEHRT).

This led to false claims charges as the software was then used by providers to win government payments in the Medicare and Medicaid EHR Incentive program. (CMS does not intend to penalize providers who used the software in good faith.)

As was first pointed out by Fierce Healthcare, on July 26 OIG posted a video describing the eClinicalWorks settlement, upon which their Senior Counsel John O'Brien provides commentary that suggests increased vigilance by OIG is in the offing:

eClincialWorks was causing healthcare providers who use its software to submit false claims to what is called the Mecicare and Medicaid EHR incentive program, and it was doing this because its software didn't actually meet the criteria required for software to be certified in this program.

We're entering an entirely new area of health care fraud... the message OIG wants to send the heathcare community is, we take the certification process for EHR software very seriously. There is not room for manipulating this process and making false statements during the certification process. OIG will vigilantly, along with its law enforcement partners, investigate any conduct that places patient safety at risk and causes losses to the federal healthcare programs. [emphasis added]

Sounds like they're serious. Watch Part B News to see if your EHR software vendor has been caught pulling a fast one.

Blog Tags: anti-fraud
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