EHR vendor Practice Fusion to pay $145 million for illegal kickback opioid scheme

January 29, 2020

The company admitted to soliciting and receiving kickbacks from a major opioid company to push doctors to prescribe the drugs, according to the Department of Justice.

Practice Fusion Inc., of San Francisco, will pay $145 million to resolve criminal and civil investigation into a kickback scheme involving the developer’s EHR software, according to a news release from the U.S. Justice Department.

To resolve the cases, Practice Fusion admitted to the scheme which say the company solicited and accepted kickbacks from an undisclosed major opioid manufacturer for using the company’s EHR programs to influence doctors to prescribe more of the drugs, the release says.

Practice Fusion agreed to pay more than $26 million in criminal fines and forfeiture. The developer paid an additional $118.6 million to settle separate civil cases with the federal state governments connected to the opioid scheme, as well as allegations that it accepted kickbacks from other drug companies and misrepresented the capabilities of the software, according to the release.

“Across the country, physicians rely on electronic health records software to provide vital patient data and unbiased medical information during critical encounters with patients,” Principal Deputy Assistant Attorney General Ethan Davis of the Justice Department’s Civil Division says in the release.  “Kickbacks from drug companies to software vendors that are designed to improperly influence the physician-patient relationship are unacceptable.  When a software vendor claims to be providing unbiased medical information-especially information relating to the prescription of opioids-we expect honesty and candor to the physicians making treatment decisions based on that information.”

According to the release, Practice Fusion accepted the kickbacks, which the company called “sponsorships,” from pharmaceutical companies for implementing clinical decision support alerts in its EHR software designed to increase prescriptions for the companies’ drugs. The developer gave the pharmaceutical companies a direct hand in developing and implementing these alerts in the EHR software, leading to alerts that did not always reflect accepted medical standards.

While pitching the scheme to pharmaceutical companies, the developer would tout the anticipated financial benefits of the increased drug sales due to the alerts, the release says.

As part of the civil settlement, Practice Fusion resolves claims that the company falsely obtained certification from the Office of the National Coordinator for Health Information Technology for several versions of its EHR software by concealing that the EHR did not comply with the applicable requirements, the release says.

“As new technologies continue to develop and evolve, so too do new and innovative fraud schemes,” says Shimon R. Richmond, assistant inspector general for Investigations of the U.S. Department of Health and Human Services, in the release “We will continue to be vigilant in detecting and investigating these schemes in order to protect the safety of patients in federal health programs and to ensure the appropriate use of electronic health records in providing their care.”