21st Century Oncology pays $26M for falsifying EHR attestation, submitting fraudulent Medicare claims

Judge banging gavel on stack of money
21st Century Oncology will pay $26 million to resolve self-disclosed Meaningful Use attestation violations. (Getty/AndreyPopov)

On the same day it inked a multimillion dollar settlement with the government for a 2015 data breach, 21st Century Cures agreed to a $26 million settlement with the Department of Justice for falsifying EHR attestations over the course of three years.

The national cancer care company, headquartered in Fort Myers, Florida, self-reported the violations to the Office of Inspector General in 2016. The settlement also resolved separate whistleblower allegations that the company submitted false claims to the Medicare program and paid kickbacks to physicians for patient referrals.

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21st Century Oncology collected EHR incentives from CMS from 2012 through 2014 by fabricating reports, falsifying data regarding the company’s use of EHR software and even superimposing vendor logos onto reports to make them seem legitimate, according to the settlement, which was approved by a New York bankruptcy court earlier this week.

“We appreciate that 21st Century Oncology self-reported a major fraud affecting Medicare, and we are also pleased that the company has agreed to accept financial responsibility for past compliance failure,” Acting U.S. Attorney Stephen Muldrow of the Middle District of Florida said in a release.

False claims liability associated with EHR incentive payments has emerged as a growing concern in the healthcare industry following the $155 million settlement paid by eClinicalWorks in June. Some attorneys have begun restructuring EHR vendor contracts as a result of the liability concerns to include specific language regarding compliance with the Office of the National Coordinator for Health IT’s certification criteria.

RELATED: Unsealed lawsuit claims 62 Indiana hospitals, Ciox Health triggered fraudulent EHR incentive payments

More healthcare providers may be on the hook for fraudulent EHR incentive payments. Earlier this year, the OIG estimated CMS spent $729 million between 2011 and 2014 on improper payments, and the agency plans to publish another report in 2018.  

Meanwhile, a lawsuit unsealed last month in Indiana names 62 hospitals, alleging providers across that state submitted fraudulent Meaningful Use data tied to medical records fulfillments for patients.