EHR Vendor Practice Fusion Admits to Kickback Scheme, Will Pay $145 Million

Practice Fusion, a San Francisco-based health IT firm, has agreed to pay $145 million to resolve criminal and civil investigations, and admit that it solicited and received kickbacks from a major opioid company in exchange for using its EHR software to influence physician prescribing of opioid pain medications, the U.S. Department of Justice announced on Monday.

Practice Fusion agreed to a deferred prosecution agreement and will pay more than $26 million in criminal fines and forfeiture, as well as $118.6 million to the federal government and states in civil settlements to resolve allegations that it accepted kickbacks and also caused users to submit false claims for federal incentives by misrepresenting its EHR’s capabilities.

According to the Justice Department:

• In exchange for “sponsorship” payments from pharmaceutical companies, Practice Fusion allowed the companies to influence the development and implementation of clinical decision support alerts in its EHR software.
• The alerts did not always reflect accepted medical standards.
• Between 2014 and 2019, healthcare providers using the EHR software wrote numerous prescriptions after receiving alerts that pharmaceutical companies had participated in designing.

The case is the first ever criminal action against an EHR vendor, the Justice Department said in a news release.

“Practice Fusion’s conduct is abhorrent,” Christina E. Nolan, U.S. attorney for the District of Vermont, said in the release. “During the height of the opioid crisis, the company took a million-dollar kickback to allow an opioid company to inject itself in the sacred doctor-patient relationship so that it could peddle even more of its highly addictive and dangerous opioids.

“The companies illegally conspired to allow the drug company to have its thumb on the scale at precisely the moment a doctor was making incredibly intimate, personal, and important decisions about a patient’s medical care, including the need for pain medication and prescription amounts.”