Modernizing Medicine To Pay $45 Million To Settle False Claims, Kickback Allegations

EHR vendor Modernizing Medicine has agreed to pay $45 million to the federal government to settle a whistleblower suit alleging that the vendor engaged in varied kickback schemes as well as causing its provider customers to submit false claims. The lawsuit was filed in 2017 by law firms Phillips and Cohen LLP and Downs Rachlin Martin PLLC. The US Department of Justice joined the case in March 2022, which now targeted founders and executives Dan Cane and Dr. Michael Sherling as well as ModMed, after conducting its own investigation. The whistleblower in the case is Amanda Long, who joined the company in 2014 and exited her role as vice president of product management in 2017. The US Department of Justice complaint alleges that from January 2010 to July 2017, the vendor engaged in multiple kickback schemes, including creating a partnership with a clinical laboratory, Miraca Life Science, through which ModMed received payments whenever its users sent lab orders to Miraca.  The DOJ also claims that ModMed provided Miraca with exclusive “enhanced” lab interfaces within the ModMed platform which would drive diagnostic testing to its facilities. These financial arrangements caused healthcare providers to submit false reimbursement claims for pathology services, along with false claims for Meaningful Use incentives arising from the use of ModMed’s technology. The complaint also alleged that ModMed paid kickbacks to its current healthcare provider customers, along with influent...
Source: EMR and HIPAA - Category: Information Technology Authors: Tags: Ambulatory C-Suite Leadership EMR-EHR Health IT Company Healthcare IT Amanda Long Dan Cane Dr. Michael Sherling EHR Whistleblower False Claims Healthcare Kickbacks Inform Diagnostics meaningful use Miraca Life Science Modernizi Source Type: blogs