Becker's Hospital Review

33 CIO / HEALTH IT 69 Indiana Hospitals Accused of Retaining $324M in Fraudulent EHR Incentive Payments By Ayla Ellison A recently unsealed lawsuit filed by at- torneys under the qui tam, or whis- tle-blower, provision of the False Claims Act accused Indiana hospitals of overcharging patients for their electronic medical records. Here are eight things to know about the lawsuit. 1. Aer experiencing difficulty obtaining medical records from four Indiana hospitals in their work on personal injury and medi- cal malpractice cases, attorneys from Ander- son, Agostino & Keller sued the hospitals in September 2016. ey alleged the hospitals falsely certified they were meaningful users of EHR technology. 2. Under meaningful use stage 1, hospitals could show compliance and receive incen- tive payments by filing attestation documents reporting compliance with core criteria re- quirements. e lawsuit against the Indiana hospitals focused on core measure No. 11, which aimed to provide patients with elec- tronic medical records within three business days of receiving a request from the patient or their agent. 3. To receive the incentive payments, hos- pitals had to show the number of medical record requests they received annually and if the records were supplied to those request- ing them within three business days. Hospi- tals that failed to meet at least 50 percent of their requests within the time frame would not be eligible to receive incentive payments. 4. Based on their experience requesting re- cords from the hospitals and aer examining public disclosures, the lawyers alleged the hos- pital defendants falsely certified compliance with core measure No. 11. 5. The lawyers also claimed the hospitals al- lowed CIOX Health, a company that provid- ed medical records for the hospitals, to ille- gally profit from the release of the electronic medical records. "CIOX routinely and repeatedly engaged in a practice, policy, and/or scheme to illegally and fraudulently over-bill patients for the provision of medical records," the complaint stated. 6. e lawyers added organizations operating an additional 65 hospitals to the lawsuit aer examining disclosures and identifying a sta- tistical trend that they argue indicates the same type of fraudulent reporting of core measure No. 11. 7. "In sum, these hospitals have been paid $324,386,169.32 in public funding from the citizens of the United States in return for the promise that patients would be provided with fast, cheap, easy access to their electronic health records, and these hospitals have failed to keep that promise," the complaint stated. "A failure to properly track and report core measure 11 means that the defendant hospi- tals did not achieve 'meaningful use' as defined by the legislation and its ensuing rules. is means that they were not eligible to receive any funding under this program, and have sought and received the grant funding at issue in a fraudulent manner that constitute false claims for public funding." 8. e Department of Justice declined to inter- vene in the lawsuit. n Judge Dismisses 84-Year-Old Computerless Physician's Plea to Regain Her License By Alyssa Rege A Merrimack County Superior Court judge dismissed a case brought forth by an 84-year-old New Hamp- shire physician who claimed the state pressured her into closing her solo practice, according to New Hamp- shire Public Radio. Anna Konopka, MD, surrendered her medical license to the state in early November to settle allegations brought by the New Hampshire Board of Medicine. While the details of the allegations are sealed, the state's claims stem from at least two separate instances, including Dr. Konopka's refusal to register with the state's mandatory opioid-monitoring program, which requires a computer. Dr. Konopka does not own a computer nor does she know how to use one. "The problem now is that I am not doing certain things on computer," Dr. Konopka previously told ABC-36 News. "I have to learn that. It is time consuming. I have no time." During a hearing earlier in Nov. 2017, she said she agreed to the NHBM's terms under duress, an act which has since caused her patients to suffer, as many of them are low-in- come and live in rural areas, according to New Hampshire Public Radio. "The Court has admiration for Dr. Konopka's devotion to her patients. Under these circumstances of this case, how- ever, Dr. Konopka has failed to demonstrate that the ex- traordinary remedy of an injunction allowing her to contin- ue to practice medicine is appropriate. To hold otherwise would be to ignore the process established by the legis- lature to regulate the practice of medicine in this state," the judge wrote in his opinion of the case, New Hampshire Public Radio reports. Dr. Konopka has filed a motion with the judge to reconsid- er, and filed affidavits from roughly 30 patients supporting her case, according to the report. n

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