Practice Fusion, Kickback Scheme, California 2024

San Francisco-based health information technology developer Practice Fusion Inc. has agreed to pay $145 million to resolve criminal and civil investigations related to its electronic health records (EHR) software.

As part of the criminal resolution, Practice Fusion admits to soliciting and receiving kickbacks from a major opioid company in exchange for utilizing its EHR software to influence physician prescribing of opioid pain medications. The company has executed a deferred prosecution agreement and agreed to pay over $26 million in criminal fines and forfeiture.

In separate civil settlements, Practice Fusion has agreed to pay a total of approximately $118.6 million to the federal government and states to resolve allegations that it accepted kickbacks from the opioid company and other pharmaceutical companies. The company is also accused of causing its users to submit false claims for federal incentive payments by misrepresenting the capabilities of its EHR software.

“Across the country, physicians rely on electronic health records software to provide vital patient data and unbiased medical information during critical encounters with patients,” said Principal Deputy Assistant Attorney General Ethan Davis. “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.”

The resolution addresses allegations that Practice Fusion extracted unlawful kickbacks from pharmaceutical companies in exchange for implementing clinical decision support (CDS) alerts in its EHR software designed to increase prescriptions for their drug products. The CDS alerts did not always reflect accepted medical standards and were influenced by pharmaceutical companies in their development and implementation.

Between 2014 and 2019, health care providers using Practice Fusion’s EHR software wrote numerous prescriptions after receiving CDS alerts that pharmaceutical companies participated in designing. Practice Fusion has agreed to pay $145 million to resolve the allegations and has executed a deferred prosecution agreement with the U.S. Attorney’s Office for the District of Vermont.

Mandatory Facts:

Defendant/Respondent: Practice Fusion Inc.

Criminal Charges: Soliciting and receiving kickbacks, causing false claims for federal incentive payments

City and State: San Francisco, California

Date: Ongoing investigation

Sentence or Outcome: Deferred prosecution agreement, $26 million in criminal fines and forfeiture, $118.6 million in civil settlements

Dollar Amounts: $145 million, $26 million, $118.6 million

Source: https://www.justice.gov/archives/opa/pr/electronic-health-records-vendor-pay-145-million-resolve-criminal-and-civil-investigations-0