One of the nation’s largest for-profit health systems is under investigation regarding the company’s adoption of electronic health records (EHRs) and adherence to federal standards that govern incentive payments.
A new disclosure buried in a recent financial filing indicates Community Health Systems is responding to a civil investigative demand “relating to the Company’s adoption of electronic health records technology and the meaningful use program.”
The federal government used the Meaningful Use program, now known as Promoting Interoperability, to distribute more than $38 billion to eligible providers to install EHR systems, including $21.7 billion to hospitals. Civil investigative demands are often used by state and federal authorities in conjunction with allegations of False Claims Act violations or fraud investigations.
While the disclosure is short on specifics, CHS indicated it is currently responding to subpoenas and administrative demands concerning the Meaningful Use program. It’s unclear based on the filing whether the CID came from a state attorney general's office or from federal investigators at the Department of Justice or the Office of Inspector General (OIG).
"At this time we do not plan to comment beyond what is in our public filing," CHS spokesperson Tomi Galin said in an emailed statement to FierceHealthcare.
Headquartered in Franklin, Tennessee, Community Health Systems operates 118 hospitals in 20 states. CHS hospitals use three different hospital EHRs: Cerner, Medhost and a homegrown solution from Health Management Associates (HMA), a 70-hospital system acquired by CHS in 2014. According to annual financial filings, CHS has received more than $865 million in EHR incentive payments through the HITECH Act between 2011 and 2017.
In 2013, HMA reported that it improperly accepted approximately $31 million in EHR incentive payments through the Meaningful Use program from July 2011 through June 2013. HMA self-reported the error to the Centers for Medicare & Medicaid Services (CMS) after an internal investigation found that 11 of its hospitals failed to meet meaningful use criteria.
Medhost spokesperson Samra Khan said it is company policy to “not make specific comments regarding customer operational or confidential matters.”
“CHS is a large and complex healthcare organization with various vendors that may have some involvement relating to its adoption of electronic health records technology and the meaningful use program,” she wrote in an email.
A Cerner spokesperson declined to comment.
EHR incentive payments have emerged as a focal point for federal investigators. Last year, the OIG said the feds issued $729 million in inappropriate incentive payments. In response to the OIG’s report, the CMS agreed to pursue $2.6 million in payments identified by auditors.
Shortly after that audit, OIG embarked on a second review of Medicare EHR incentive payments, which it is scheduled to publish this year.
Few instances of hospitals falsely obtaining EHR incentive payments have been documented. In 2015, a Texas hospital chief financial officer was sentenced to nearly two years in prison and ordered to pay back $4.5 million to Medicare’s EHR incentive program.
Last year, EHR vendor eClinicalWorks paid $155 million to settle claims it violated certification requirements, causing providers to falsely submit incentive reimbursement.
Additionally, the CHS has received an “inquiry” regarding its use of the Windows 2003 operating system. Microsoft sued the health system earlier this year for “willful copyright infringement,” alleging that CHS allowed hospitals it sold off to continue using Microsoft products hosted on CHS servers.