A software developer of an electronic health records system utilizing AI is the recent target in a DOJ fraud investigation.
On January 27, 2020, the DOJ announced that Practice Fusion, Inc. entered into a deferred prosecution agreement with the DOJ for taking $1 million in kickbacks from a pharmaceutical company for sending clinical-support decision alerts to providers utilizing its EHR system to encourage the prescription of opioids. Such alerts are intended to assist physicians with appropriate treatment decisions. Practice Fusion will pay $145 million to resolve the criminal and civil investigations relating to this issue.
The EHR system developed by Practice Fusion did not comply with regulatory requirements for health IT certification, according to the DOJ. While the Department of Health & Human Services contemplates whether changes in the regulation are necessary to preserve the integrity of decision alerts embedded in EHR systems, DOJ will likely continue to scrutinize the software developers.