In the case, the United States v. Greenway Health, LLC (Greenway), allegations were made against Greenway, a Florida-based developer of EHR, to pay $57.25 million in a resolution of a False Claims charge. The payment is to resolve claims that Greenway caused the users of their EHR product “Prime Suite” to submit false claims to the government and also made provision for illicit payments to users to influence them to recommend Prime Suite to other customers.
According to the Criminal Lawyer Group’s criminal defense attorneys, this is one of the two most significant recoveries in the history of the District of Vermont, representing over $212 million in fraudulent returns of taxpayers’ money.
The Medicare and Medicaid EHR incentive program was part of the American Recovery and Reinvestment Act of 2009 to appropriately put the EHR technology to beneficial use. To ensure that the EHR technology is fit for use in the healthcare provision, all such software is required to go through a certification process facilitated and authorized by the HHS and its certification criteria.
Lawyers representing the government lodged complaints in court against Greenway regarding a false acquisition of certification for their product, Prime Suite. It further stated that a test-run software was prepared by Greenway to deceive the company hired to certify their product into allowing them to use the requisite clinical vocabulary.
Two more allegations were brought against Greenway by the lawyers representing the government. One was that the users of the product were compelled to lay false claims to EHR payment incentives when Greenway knew very well that the data these users were using to apply the claims to these payments were false as a result of incorrect calculations by an earlier version of their product, the Prime Suite. The other allegation was regarding the violation of one of the two federal laws instituted to curtail kickbacks, the Anti-Kickback statute. Greenway is alleged to have violated this statute when they paid incentives to their client providers to persuade prospective customers to go in for Prime Suite.
Greenway had come under indictment of the False Claims Act and was thus compelled to agree to enter a five-year Corporate Integrity Agreement (CIA) with the HHS Office of Inspector General (HHS-OIG) covering the company’s EHR software. This agreement will require Greenway to conform to certain measures, including retaining an Independent Review Organization to review the company’s compliance to the Anti-Kickback Statute; to ensure a review on the company’s software quality control. The CIA will also ensure that Greenway makes sure customers of the Prime Suite get the latest version of the software.
