News  |    |  January 29, 2020

Opioid Case Spotlights Use of AI for Health-Care Fraud

News article by Christopher Brown.
Published by Bloomberg Law.

Excerpt:

A software developer’s scheme to rig alerts to doctors so they would write more opioid prescriptions shows that bringing artificial intelligence into health-care decision-making has opened up new possibilities for fraud.

Practice Fusion Inc. created an electronic health records system and took $1 million in kickbacks from a drugmaker in return for sending the alerts, the Justice Department said in announcing it had reached a deferred prosecution agreement with the company. Reuters reported Tuesday that Purdue Pharma is the drugmaker, identified in court documents as “Pharma Co. X.”

The case highlights a weakness in federal regulations for electronic health records, or EHR, systems, which are built on the idea that transparency will provide protection to patients, Jacob Reider, former deputy national coordinator for health information technology during the Obama administration, said. [ . . . ]

Department of Justice Press Release:
Electronic Health Records Vendor to Pay $145 Million to Resolve Criminal and Civil Investigations