Epic Systems has been reportedly hit with a serious False Claims Act suit which claims the Healthcare IT giant’s billing system double bills the government when it comes to anesthesia services.
The motioned lawsuit was made public last week and it claimed that there was a glitch in the system that was actually causing hundreds of millions of dollars in overbilling.
Epic, on the other hand, has refuted all allegations.
Regarding the lawsuit, Epic spokeswoman Meghan Roh revealed in a statement, “The Department of Justice did its own expert review and decided not to move forward.”
“The plaintiff’s assertions represent a fundamental misunderstanding of how claims software works,” she added.
There are reports that claim that this is still not the end of the case. A prominent Healthcare IT news source revealed Linesch Firm Associate Attorney Daniela Carrión saying, “The seal has been lifted and the defenders are going to be served,” said Linesch Firm Associate Attorney Daniela Carrión.
Interestingly the said lawsuit was actually first filed in 2015, yet it remained sealed until last week. Now the lawyers are ready to proceed with it.
While working at WakeMed Health in Raleigh, North Carolina, Geraldine Petrowski filed the mentioned complaint and implied that the billing software of Epic was actually charging for both the actual time taken for the procedure as well as the applicable “base units” for anesthesia mentioned on a medical process/operation. This resulted in payers being heavily overcharged for anesthesia. Petrowski worked at WakeMed Health in Raleigh between 2008 and 2014.
In his complaint, Petrowski expressed her views saying, “This unlawful billing protocol has resulted in the presentation of hundreds of millions of dollars in fraudulent bills for anesthesia services being submitted to Medicare and Medicaid as false claims.”
Petrowski also aims to bolster her case with the allegation that a cancer center was actually billed for seven hours of anesthesia whereas the actual process only took less than five hours. The patient was billed for prostate removal at MD Anderson Cancer Center.
Initially, Petrowski worked as a compliance review specialist at WakeMed Health but was then promoted to the supervisor of physicians’ coding.
