On July 14, the Department of Justice announced NextGen Healthcare Inc., an electronic health record (EHR) technology vendor, reached a settlement of $31 million to resolve allegations of violating the False Claims Act (FCA). 

According to the government, NextGen Healthcare misrepresented certain EHR software versions and provided remuneration to influence software recommendations. Purportedly, NextGen obtained certification for its software using an auxiliary product during testing, which led to certain critical functionalities not being fully disclosed, such as the ability to record vital sign data and create complete clinical summaries.

Additionally, NextGen Healthcare was accused of violating the Anti-Kickback Statute by providing remuneration, including credits and other incentives, to customers whose recommendations resulted in new sales. The Anti-Kickback Statute prohibits the exchange of remuneration to induce referrals of items or services covered by federal programs like Medicare and Medicaid.

This case involved the qui tam provision of the False Claims Act, which allows private individuals, commonly known as whistleblowers, to file lawsuits on behalf of the government when they have evidence of fraudulent activities. In this instance, healthcare professionals Toby Markowitz and Elizabeth Ringold, who utilized NextGen’s software at their facility, filed a qui tam action against the company. As a result of their involvement, they are entitled to $5,580,000 of the settlement amount.

The settlement highlights the government’s endeavor to combat healthcare fraud and whistleblowers’ significant role in exposing potential fraudulent practices. “The Civil Division is committed to protecting the integrity of the electronic health records software that is available to providers and the process by which they decide which software to select,” said Principal Deputy Assistant Attorney General Brian Boynton, head of the Justice Department’s Civil Division.

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with white-collar criminal investigations and false claims allegations.  If you need assistance with such a matter, please contact us today.