On November 1, 2022, the Department of Justice ("DOJ") announced that Florida-based electronic health record ("EHR") vendor, Modernizing Medicine ("ModMed"), agreed to a $45 million settlement with the United States to resolve civil claims that it violated the False Claims Act ("FCA") and Anti-Kickback Statute ("AKS") by accepting and providing unlawful remuneration in exchange for referrals, causing users to submit tainted claims for federal incentive payments.1 The settlement reflects DOJ's heightened focus on EHR companies and the growing role that health technology plays in managing and directing patient care. EHR companies and those who do business with them, including life sciences companies, should structure their arrangements thoughtfully to ensure sufficient safeguards to protect against potential abuses.
Allegations
The Anti-Kickback Statute prohibits the exchange, or offer to exchange, of anything of value to induce the referral of, or recommend or arrange for, business covered by Medicare, Medicaid, and other federal health care programs. The claims against ModMed were initiated on September 22, 2017 through a whistleblower suit filed pursuant to the FCA's whistleblower provisions. The Relator, a former vice president of product management at ModMed, filed the action on behalf of the United States in the United States District Court for the District of Vermont.2 DOJ intervened on March 15, 2022.3
In its Complaint in Intervention, which was filed on the same...
Welcome to Reality Check, NewsGuard’s nonpartisan newsletter that tracks the false claims and conspiracy theories that shape our world — and who’s behind them. Please support us by becoming a premi...