Dozens of lawsuits filed by whistleblowers allege that software developed and marketed to hospitals and medical professionals contains significant glitches. As reported by The North Bay Business Journal, the electronic health records (EHR) software contains undisclosed flaws that may open physicians up to health care fraud charges.
Purportedly, the EHR software’s design flaw may cause it to generate inaccurate drug codes, which may then result in physicians prescribing unusual dosages of prescription pills to patients. Approximately 40% of the software systems reviewed displayed defects that could harm patients and also hold a physician liable for deaths or serious injuries.
When an audit turns up prescription inaccuracies, a doctor may face fraud charges if his or her office bills insurance companies or Medicare for controlled substances. Because of the widespread abuse of prescription pills in California and across the nation, law enforcement officials have begun to crack down on doctors they suspect are gaming the system. Officials also suspect the developers of the glitch-hampered EHR software also gamed the system by allegedly rigging the pre-release certification process.
According to the Health and Human Services’ Office of Inspector General, 165 medical professionals faced felony fraud charges during 2018. 32 physicians allegedly prescribed and distributed dangerous opioids and narcotics, which officials claim contributed toward $2 billion in annual losses by U.S. health care programs.
A fraud conviction requires that a prosecutor prove — beyond any reasonable doubt — that a doctor had the intent to receive funds or a financial benefit through deceptive means, such as by creating fictitious ailments. However, a physician who has maintained meticulous records of his or her patients and their prescription needs may have a strong defense to counteract any allegations of wrongdoing.
