Practice Fusion to pay $145M settlement, resolves kickback allegations: 7 key details

Practice Fusion admitted to receiving kickbacks from a major opioid company in exchange for using its EHR platform to influence physician prescription and will pay a multimillion-dollar fine to resolve the investigation.

The tentative agreement was reached in August, and the U.S. Attorney's Office District of Vermont released the details today. Seven things to know:

1. Practice Fusion admitted to implementing clinical decision support alerts in its software to increase opioid prescriptions. The company received "sponsorship payments" from pharmaceutical companies, which influenced the CDS alert development and implementation.

2. Pharmaceutical companies participated in designing the CDS alerts, including setting the guidelines and criteria that would help determine when providers received an alert. However, the alerts didn't always reflect accepted medical standards, according to the Department of Justice release.

3. Practice Fusion received around $1 million from an opioid company, which was not named by the Justice Department, to create the CDS alert causing physicians to write prescriptions for additional extended release opioids. Practice Fusion entered into a contract with the unnamed opioid company on March 1, 2016.

4. Practice Fusion told the large opioid company that its involvement in developing the CDS alert would result in physicians prescribing additional opioids.

5. Practice Fusion agreed to pay $145 million to resolve criminal and civil investigations, including $26 million in criminal fines and forfeiture. The payment also comprises $118.6 million in separate civil settlements, including 13 other CDS arrangements with pharmaceutical companies.

6. The civil settlement also resolves allegations that Practice Fusion falsely represented whether its software met data portability requirements when it sought certification from the Office of the National Coordinator for Health Information Technology 2014 Edition. As a result, healthcare providers using its software falsely attested to compliance with HHS requirements because they thought Practice Fusion's 2014 Edition EHR met requirements.

7. Practice Fusion entered into a Deferred Prosecution Agreement that requires it to:

• Forfeit nearly $1 million in criminal proceeds
• Pay $25.4 million criminal fine
• Cooperate with ongoing investments of the kickback arrangement
• Report evidence of other EHR vendors violating the Anti-Kickback Statute
• Retain independent oversight to review and approve sponsored CDS prior to implementation
• Develop a comprehensive compliance program

Allscripts acquired Practice Fusion in 2018 for $100 million.

"We are pleased to complete the settlement of these legacy matters, which as disclosed last August involve conduct predating Allscripts' acquisition of Practice Fusion," said Brian Farley, Allscripts executive vice president, general counsel and chief administrative officer. "As a company, we are committed to maintaining the highest levels of professionalism and integrity, and since learning of this matter we have further strengthened Practice Fusion's compliance program."

Note: This article was updated on Feb. 1 at 4:46 pm CST to reflect that Practice Fusion entered into a written agreement with the unnamed pharmaceutical company on March 1, 2016. Readers may have inferred from a previous version of this article that the partnership began in 2014. To clarify, the CDS program went live in 2014 and the opioid program went live in 2016, after Ryan Howard departed as CEO. 

 

© Copyright ASC COMMUNICATIONS 2021. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Featured Whitepapers

Featured Webinars