Is Your EHR Getting Sued for False Claims Violations?

If your electronic health record (EHR) is Modernizing Medicine (ModMed), then yes, it is getting sued for a violation of the False Claims Act.

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The Federal Government decided to intervene in a lawsuit against the EHR vendor that was founded in 2010. ModMed is used by orthopedists, otolaryngologists, and dermatologists.

The lawsuit was brought by a whistleblower who alleged that the company made false statements to market software and obtain certification. The company manually changed displays to make it seem as though the software had capabilities that didn’t actually exist. The whistleblower also said the software was unreliable and caused safety risks for patients.

The lawsuit also alleges that ModMed inappropriately influenced prescription of certain drugs, which earned ModMed money. There were also allegations of illegal referrals and billing codes that generate higher revenues.

ModMed denies all allegations.

The False Claims Act allows the government to recover funds when false or fraudulent claims were submitted for payment to the government. 

While it’s unlikely that you would know if your EHR was violating the law, it’s essential that you protect your own practice from being involved in False Claims Act lawsuit. 

Protect your practice by auditing your billing. Make sure to audit internally and make use of external auditors. We recommend working with healthcare attorneys to protect the findings with attorney-client privilege. 

Make sure your compliance plan is up to date and your staff is routinely trained. It is also essential that your staff feels comfortable in reporting any potential concerns. 

You should have a way to anonymously report concerns and make sure your staff knows they are taken seriously. This can help to avoid potential whistleblower lawsuits. 

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