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Greenway to Pay $57.25M for False EHR Certification Allegations

Greenway has agreed to pay more than $57 million to settle allegations about falsely meeting EHR certification criteria and violating kickback rules.

EHR certification criteria and Greenway false attestation

Source: Thinkstock

By Jennifer Bresnick

- Greenway Health LLC has agreed to pay $57.25 million to resolve complaints that its “Prime Suite” EHR product caused users to submit false information to the EHR Incentive Programs.  The federal government has also accused the company of falsely obtaining 2014 Edition Certified EHR Technology (CEHRT) status.

The allegations claimed that Greenway misrepresented the capabilities of its product to customers and provided unlawful remuneration to users for positive recommendations to peers, violating the Anti-Kickback Statute.

“Electronic health records are critically important to the health care decision process, and both patients and providers rely on these technologies to safely and accurately record and transmit vital health information,” said Assistant Attorney General Jody Hunt of the Department of Justice’s Civil Division. 

“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.”

The federal government contends that Greenway’s Prime Suite product did not fully comply with the criteria for certified technology under the 2014 Edition guidelines.

READ MORE: AMA Offers Guidance for EHR Vendor Selection in New Playbook

“Among other things, Greenway’s product did not incorporate the standardized clinical terminology necessary to ensure the reciprocal flow of information concerning patients and the accuracy of electronic prescriptions,” the Department of Justice stated. 

“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.”

The DOJ further states that Greenway “refrained from rectifying” a known flaw in its 2011 Edition product that miscalculated the percentage of patients who received clinical summaries after a visit. 

The improper calculation was carried forward into the 2014 Edition, resulting in some organizations making false attestations of eligibility for EHR Incentive Program payments.

“In the last two years my office has resolved two matters against leading EHR developers where we alleged significant fraudulent conduct,” said United States Attorney Christina E. Nolan for the District of Vermont, referring to the $155 million settlement involving similar accusations against eClinicalWorks in May of 2017. 

READ MORE: How New Federal Regulations Affect EHR Vendors, Health IT Innovation

“These are the two largest recoveries in the history of this District and represent the return of over two-hundred and twelve million dollars of fraudulently-obtained taxpayer monies,” continued Nolan.  “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.”

“This resolution demonstrates my office’s initiative and resolve to vigorously uncover and to doggedly pursue these complex cases.  We will be unflagging in our efforts to preserve the accuracy and reliability of Americans’ health records and guard the public against corporate greed.  EHR companies should consider themselves on notice.”

As part of the settlement, Greenway will participate in a Corporate Integrity Agreement (CIA) with the HHS Office of Inspector General (HHS-OIG) for the next five years.

Greenway will be required to retain an independent review organization to assess the company’s EHR products and review partnerships with healthcare organizations for compliance with the Anti-Kickback Statute.

The agreement also requires Greenway to allow Prime Suite customers to access the latest version of the software at no extra charge or migrate to a different Greenway product without additional cost.

READ MORE: 4 Tips for Successfully Navigating EHR Vendor Relationships

Greenway customers will also have the option to switch to a different EHR vendor entirely without service charges or penalties other than contractual amounts owed for services already rendered.

“Electronic health records can be key to an integrated health system providing improved care” said Derrick Jackson, Special Agent in Charge for the Office of Inspector General of the US Department of Health and Human Services.

“Putting patients at risk will result in intensive investigation and compliance obligations such as those in OIG’s comprehensive five-year Corporate Integrity Agreement.”

Editor's note: Greenway Health CEO Rcihard Atkin has issued the following statement on the settlement.

“Greenway Health today announced a settlement with the US Department of Justice regarding the government’s allegations that our Prime Suite product failed to comply with certain certification and legal requirements resulting in overpayments or improper payments to healthcare providers. 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.”

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