Modernizing Medicine Inc. (ModMed), an electronic health records (EHR) vendor, has agreed to pay a $45 million fine for allegedly accepting payment in exchange for referrals and reporting incorrect information regarding users’ ability to receive federal incentives, according to a Department of Justice press release.
Passed as part of the Social Security Amendments in 1972, the Anti-Kickback Statute prohibits anyone from offering or paying for referrals of items covered by federal programs like Medicare and Medicaid, the release says. ModMed allegedly solicited and received kickbacks from Miraca Life Sciences Inc., who paid a $63 million fine for similar offenses in 2019, for directing customers ModMed’s way. The two further partnered to donate ModMed’s services to providers so they would send lab orders to Miraca. And ModMed was charged with giving referral bonuses to providers for bringing ModMed new customers.
On top of those allegations, ModMed was found to falsely advertise that their services would make customers eligible for Health and Human Services’ EHR incentive programs. These payments go to providers who use certified EHR technology that, among other things, uses standardized vocabulary for medications and clinical terminology. These alleged infractions came to light under a qui tam suit filed by Amanda Long in the District of Vermont.
