Practice Fusion Fined $145M for Opioid Prescribing Kickback Scheme

January 28, 2020

Practice Fusion’s “abhorrent” conduct has resulted in a record-setting fine in the state of Vermont after pocketing $1 million in an opioid prescribing kickback scheme.

EHR vendor Practice Fusion will pay a historic $145 million fine after admitting to a kickback scheme aimed at increasing opioid prescriptions, according to a statement released by the Department of Justice for the District of Vermont.

Practice Fusion admitted that it solicited and received kickbacks from a major, unnamed opioid company in exchange for utilizing its EHR software to manipulate physician prescribing of opioid pain medications.

“Practice Fusion’s conduct is abhorrent,” said United States Attorney for the District of Vermont, Christina E. Nolan. “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.”

The Department of Justice said the vendor implemented clinical decision support (CDS) alerts in its EHR software to increase the sales of specific opioids.

The pharmaceutical companies “sponsoring” Practice Fusion could design and develop the CDS alerts. The companies also helped develop guidelines and criteria to generate physician alerts during the treatment process.

“The companies illegally conspired to allow the drug company to have its thumb on the scale at precisely the moment a doctor was making incredibly intimate, personal, and important decisions about a patient’s medical care, including the need for pain medication and prescription amounts,” Nolan continued.

“This recovery is commensurate to the nature of Practice Fusion’s misconduct, represents the largest criminal fine in the history of this District, and requires Practice Fusion to admit to its wrongs.”

Between 2014 and 2019, Practice Fusion garnered $1 million in “sponsorship” that were based on the CDS recommendations, according to the Department of Justice.

“It is another example of pioneering healthcare fraud enforcement by the talented Assistant US Attorneys and staff of this US Attorney’s Office, working with their partners in law enforcement,” said Nolan. “We cannot—and will not—tolerate technology companies influencing patient treatment merely because a pharmaceutical company provided a kickback.”

This is the first ever criminal action against an EHR vendor. Practice Fusion will be forced to accept responsibility and ensure transparency to its conduct and invest heavily in compliance overhauls.

The EHR developer will pay the $145 million fine to settle both the criminal and civil investigations. The company agreed to pay roughly $118.6 million to the federal government and states in separate civil settlements. Meanwhile, they agreed to pay over $26 million in criminal fines and forfeiture.

The EHR vendor was also charged with two felony counts of violating the Anti-Kickback Statute (AKS) and for conspiring with the unnamed opioid company to violate the AKS.

“Across the country, physicians rely on electronic health records software to provide vital patient data and unbiased medical information during critical encounters with patients,” said Principal Deputy Assistant Attorney General Ethan Davis of the Department of Justice’s Civil Division.

“Kickbacks from drug companies to software vendors that are designed to improperly influence the physician-patient relationship are unacceptable,” Davis concluded. “When a software vendor claims to be providing unbiased medical information – especially information relating to the prescription of opioids – we expect honesty and candor to the physicians making treatment decisions based on that information.”

In January 2018, Allscripts announced the acquisition of Practice Fusion in a $100 million cash deal to further expand its reach into ambulatory care settings.


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