A Tampa software developer has agreed to pay $57.25 million to settle allegations from the government that it violated Federal law by allowing users to submit false claims to government health care insurers.
Investigators say the developers violated the False Claims Act (a.k.a. “the Lincoln Law”) when it took advantage of a program to encourage Medicare and Medicaid providers to adopt electronic health records (EHR) systems by claiming that the software it developed met guidelines necessary for certification under the program.
Rather than programming their software to recognize standard clinical terminology in order to allow it to receive and transmit critical information regarding patients and their prescriptions, investigators say the firm altered a mock-up program to deceive the company in charge of issuing certifications into believing that the full program did the same.
In addition, investigators say the program allowed users to submit false claims to the government in order to obtain incentive payments. They say the program miscalculated benchmarks set for clinics to obtain the incentives, essentially allowing a significant number of users to claim benefits for which they were not entitled.
Lastly, federal investigators say the firm offered incentives to buyers for using the program. Such incentives run afoul of the federal Anti-Kickback Statute.
In addition to the settlement payment, the company agreed to entering into a five-year Corporate Integrity Agreement (CIA) program. The program is designed to evaluate the firm’s software quality control and compliance systems and to evaluate its relationships with its customers to insure that they do not run contrary to the spirit and letter of the Anti-Kickback Statute.
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