The lawsuit was filed as an alleged violation of the federal False Claims Act.
A recently unsealed federal whistleblower lawsuit alleges that dozens of Indiana hospitals engaged in a pattern of overcharging patients for their electronic medical records (EMRs), according to a recent report in Becker’s Hospital Review.
The report by Ayla Ellison noted that the alleged misconduct involved nearly $325 million in retained fraudulent payments among a total of 69 hospitals across The Hoosier State. The lawsuit was filed as an alleged violation of the federal False Claims Act.
“After experiencing difficulty obtaining medical records from four Indiana hospitals in their work on personal injury and medical malpractice cases, attorneys from Anderson, Agostino & Keller sued the hospitals in September 2016,” the report read. “They alleged the hospitals falsely certified they were meaningful users of EHR technology.”
Under Stage 1 of Meaningful Use, the report noted, hospitals could receive incentive payments by filing attestation documents reporting compliance with core criteria requirements. The lawsuit against the Indiana hospitals focuses on core measure No. 11, which aimed to provide patients with electronic medical records within three business days of receiving a request from the patient or their agent.
“To receive the incentive payments, hospitals had to show the number of medical record requests they received annually, and if the records were supplied to those requesting them within three business days. Hospitals that failed to meet at least 50 percent of their requests within the time frame would not be eligible to receive incentive payments,” the report read. “Based on their experience requesting records from the hospitals and after examining public disclosures, the lawyers alleged the hospital defendants falsely certified compliance with core measure No. 11.”
The attorneys involved in the lawsuit also reportedly claim that the hospitals allowed CIOX Health, a company that provided medical records for the hospitals, to illegally profit from the release of the electronic medical records.
To read the Becker’s Hospital Review article in its entirety, go online to https://www.beckershospitalreview.com/legal-regulatory-issues/69-indiana-hospitals-accused-of-overbilling-for-medical-records-in-324m-scheme.html.
The U.S. Court of Appeals for the Sixth Circuit has handed the False Claims Act (FCA) bar another lesson in humility – and perhaps prompted
I recently offered training to a health system about how to respond to whistleblower complaints. Regular readers will know many of the tips I discussed.
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