2022年11月16日

嵌入,代码复制并粘贴到你的网站或者博客:< iframe帧边缘= = " 620 "滚动=“1”高度src = " / /www.jdsupra.com/post/contentViewerEmbed.aspx?“汽车”fid = a10481ac-ef4e-41de-a591-a6d6b919c0f1”风格= "边境:2 px固体# ccc;overflow-x:隐藏!重要;溢出:隐藏;“宽度= " 100% " > < / iframe >司法部继续堆积医疗执法行动——虚假声称,anti-kickback,和欺诈行为。司法部在创纪录的一年。在最近的一次执法行动,现代化医学(“ModMed”),电子健康记录(EHR)供应商,同意支付4500万美元部和虚假申报法违规收受贿赂换取推荐,导致用户信息错误报告联邦奖励。部(法令禁止任何人提供或支付,直接或间接地,任何报酬、金钱或其他任何东西的价值,确保推荐的物品或服务覆盖的医疗保险、医疗补助和其他联邦政府资助的项目)。ModMed违反了虚假申报法》通过三个营销计划:首先,ModMed请求和收到Miraca回扣生命科学(“Miraca”)以换取推荐和安排ModMed利用Miraca病理服务的用户。2010年1月至2013年12月,ModMed促进EHR捐款ModMed顾客Miraca不符合部的要求,因为捐赠决策考虑的数量或价值之间的实验室测试或其他业务推荐EHR受助人,ModMed客户和Miraca部,因此不符合要求的安全港例外适用于EHR捐款,42 C.F.R.§1001.952 (y)。ModMed客户提交污染申请报销病理服务的联邦医保计划从2010年1月至2013年12月由Miraca,并提交污染索赔有意义使用奖励根据美国卫生和公众服务部EHR激励计划(“有意义的使用项目”)的医疗保险和医疗补助服务中心(CMS)。第二,ModMed伙同Miraca不当捐赠ModMed EHR卫生保健提供者增加实验室命令Miraca并添加客户ModMed的用户基础。 In September 2013, Miraca paid ModMed an initial fee and increased transaction fees to develop and include in its EHR software, certain enhanced interface features that ModMed agreed, for a period of time, not to offer to any other pathology laboratory. Third, ModMed paid kickbacks to its current health care provider customers and other influential sources in the healthcare industry to recommend ModMed’s EHR and refer potential customers to ModMed. As a result, the United States alleges that between January 2010 and July 2017, ModMed users submitted tainted claims for incentive payments under the Meaningful Use Programs. The electronic health record industry has been the focus of False Claims Act investigations and enforcement actions. DOJ’s focus recognizes EHRs are critical to informing physician decision making and ensuring that healthcare providers select EHR technologies free from improper influence. According to DOJ, ModMed improperly generated sales for itself and for Miraca, while causing health care providers to submit false claims for reimbursement for pathology services and for incentive payments for the adoption of ModMed’s EHR system. In January 2019, Miraca agreed to pay $63.5 million to resolve allegations it violated AKS and Stark Law by providing to referring physicians subsidies for EHR systems and free or discounted technology consulting services. The False Claims Act was initiated by a qui tam relator, who received a payment of $9 million out of the $45 million settlement.