Justice Department investigators are scrutinizing the healthcare industry's use of AI embedded in patient records that prompts doctors to recommend treatments. Prosecutors have started subpoenaing pharmaceuticals and digital health companies to learn more about generative technology's role in facilitating anti-kickback and false claims violations, said three sources familiar with the matter.. Two of the sourcesspeaking anonymously to discuss ongoing investigations"said DOJ attorneys are asking general questions suggesting they still may be formulating a strategy. "I have seen" civil investigative demands "that ask questions about algorithms and prompts that are being built into EMR systems that may be resulting in care that is either in excess of what would have otherwise been rendered, or may be medically unnecessary," said Jaime Jones, who co-leads the healthcare practice at Sidley Austin. DOJ attorneys want "to see what the result is of those tools being built into the system." The probes bring fresh relevance to a pair of 2020 criminal settlements with Purdue Pharma and its digital records contractor, Practice Fusion, over their collusion to design automated pop-up alerts pushing doctors to prescribe addictive painkillers. The kickback scheme ... led to a $145 million penalty for Practice Fusion. Marketers from Purdue ... worked in tandem with Practice Fusion to build clinical decision alerts relying on algorithms.
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