An electronic health record (EHR) system developer agreed to pay $145 million to settle charges that it was involved in a kickback scheme to increase opioid prescriptions, .
Practice Fusion, a cloud-based EHR vendor based in San Francisco, admitted that it received a nearly $1-million payment from a "major opioid company" to develop software that encouraged doctors to prescribe more opioids.
That money came out of the unnamed drugmaker's marketing budget, DOJ said.
The startup implemented clinical decision support (CDS) alerts -- a key function of health information technology platforms -- that marketed extended-release opioids to healthcare providers, according to DOJ.
It will pay $26 million in criminal fines and $118.6 million in civil settlements. This is the first time criminal action has been taken against an EHR vendor, according to DOJ.
"Practice Fusion's conduct is abhorrent," Christina Nolan, U.S. Attorney for the District of Vermont, said in the . "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."
"We cannot -- and will not -- tolerate technology companies influencing patient treatment merely because a pharmaceutical company provided a kickback," Nolan said.
According to court documents, Practice Fusion and the unnamed pharmaceutical company discussed the benefits that CDS alerts would have for the drug company's revenues. Practice Fusion allegedly marketed their medical software as having the potential to influence prescribing behavior, and to counteract the declining rate of opioid prescriptions that resulted from heightened public awareness of the opioid crisis.
The startup received "sponsorship" payments from the drugmaker and allowed it to get involved in the design and implementation of their EHR software for marketing purposes. The drugmaker participated in the alert development process, determining under what circumstances a healthcare provider would receive an alert, or sometimes even drafting CDS alert language.
Practice Fusion did the same thing in 13 other CDS arrangements with other pharmaceutical companies, which was included in the civil settlement, according to DOJ.
The department also said that healthcare providers "wrote numerous prescriptions" after getting the CDS alerts that pharma companies had a hand in designing.
Dan O'Neill, a health policy fellow at the National Academy of Medicine in Washington, D.C., who worked at Practice Fusion several years ago, referred to Practice Fusion as "a bit of a cautionary tale" for emerging healthcare technology companies.
In a fee-for-service healthcare landscape that encourages volume over quality, O'Neill said companies may struggle to find the balance.
"You can boost volume, but a lot of that is harmful," O'Neill told 番茄社区 in an interview. "When any startup tries to build up in today's healthcare system, they find it more difficult to 'do well by doing good,' than to just profit from the existing system."
Criminal charges against Practice Fusion included two felony counts of violating the anti-kickback statute. The civil settlement covers the company's civil liability from submitting false claims to federal healthcare programs corrupted by the kickback payments.
The DOJ statement didn't indicate whether the opioid drugmaker involved in the scheme would also face sanctions.