Eye on Oversight – Electronic Health Records


Accurate medical records, including electronic
health records, or EHR, are the foundation of providing quality healthcare to patients. If an electronic health records company falsely
represents that its software has functions that it actually lacks, patient safety could
be at risk. Senior Counsel John O’Brien explains. Data is inputted into an EHR system that reflects
the care that is provided and it’s very critical, just like in the written, the old
medical records, that everything be accurate. If there are any defects in that software
program, then critical tests, medical prescriptions may not be accurately processed, and that
could have detrimental effects on patient care. In May 2017, one of the nation’s largest
electronic health record software companies, eClinicalWorks – and three of its employees
– agreed to pay $155 million to the government to settle alleged violations of the False
Claims Act because the company misrepresented the capabilities of its software. eClinical Works was causing healthcare providers,
who use its software to submit false claims to what is called the Medicare and Medicaid
EHR Incentive Program. And it was doing this because its software
actually didn’t meet the criteria required for software to be certified in this program. This settlement is important because it’s
the first settlement with an Electronic Health Records software company. So we’re entering in an entire new area
of healthcare fraud. As part of this settlement, eClinicalWorks
signed a five-year Corporate Integrity Agreement with our office that requires the company
to take several corrective steps to continue to participate in federal healthcare programs. Patients should care about this settlement
because just about everyone of us relies on the accuracy of their Electronic Health Records. The message that OIG wants to send to the
healthcare community is that we take the certification process for EHR software very seriously. There is no 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 patients’ safety at risk, and that causes
losses to the federal healthcare programs.

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