Two South Bend lawyers have instigated a civil suit that accuses dozens of healthcare facilities of perpetrating fraud related to federal grants awarded for the implementation of electronic medical records. The complaint claims the hospitals overcharged for the release of patient files, clearing more than $300 million in fraudulent payments from federal and state agencies.
According to a report in the South Bend Tribune, attorneys with the law firm Anderson, Agostino & Keller originally brought the suit on the behalf of the federal government and the state of Indiana in the fall of 2016. It was recently unsealed.
The case hinges on the ability of hospitals to meet a provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act, which provides grant money to healthcare facilities upgrading to electronic health record systems. The suit alleges 62 Indiana hospitals routinely failed to deliver requested files within three business days. Hospitals must hit that timeframe at least 50 percent of the time to maintain grant funding.
The attorneys identified the issue while acting on behalf of clients in malpractice and personal injury cases. After growing frustrated about various hospitals lagging in provided requested records, the lawyers did additional research and determined that facilities across the state were similarly negligent. The lawyers further allege that inaccurate information was willfully provided to government agencies in order to preserve grants.
In addition to the 62 hospitals, the suit specifically identifies healthcare information management company Ciox Health as a defendant. The attorneys allege that Ciox consistently failed to meet the three day deadline for medical record release of information request.
“Each and every time that CIOX issued billing invoices for the provision of medical records, it was for an amount that exceeded the labor costs of compliance, often seeking hundreds of dollars for the provision of medical records,” the filing adds.
The lawsuit seeks financial payment reaching “three times the actual damage amount suffered by the United States for all funding issued to the Defendants under the EHR Program.” That would put total damages paid by the hospitals at over $1 billion.
Filed Under: Industry regulations
