In a brief mention contained in its Form 10-Q, filed with the U.S. Securities & Exchange Commission, publicly-traded Community Health Systems revealed that it is facing a "civil investigative demand" related to its "adoption of electronic health records technology and the meaningful use program."

There were few details in the note, contained on page 78 of the 86-page filing, but the EHR investigation, first reported by Fierce Healthcare, was listed fourth among other topics for which CHS, the largest for-profit acute care hospital chain is "responding to subpoenas and administrative demands" – including "short-term Medicaid eligibility determinations processed by third party vendors at one of our Pennsylvania hospitals" and "an inquiry regarding computer servers running the Windows 2003 operating system."

[See also: Microsoft sues Community Health Systems for alleged copyright infringement]

It wasn't clear from the filing which federal agency would be looking into the meaningful use participation of Tennessee-based CHS, although the incentive program (which has since evolved into the Promoting Interoperability initiative) was administered by the Centers for Medicare & Medicaid Services. 

In its 10-Q, the hospital network noted that it occasionally fields "inquiries or subpoenas from state regulators, state Medicaid Fraud Control units, fiscal intermediaries, the Centers for Medicare and Medicaid Services, the Department of Justice and other government entities regarding various Medicare and Medicaid issues."

A request for comment from Community Health Systems was not immediately returned.

A civil investigative demand has been described as an "increasingly aggressive investigative tool" that the government can use to investigate complaints related to the False Claims Act.

As one health law firm explains, a CID offers wider latitude for federal probes of civil complaints, compared with other tools used to investigate potential fraud or overbilling.

"Unlike other investigatory tools (such as grand jury subpoenas), a federal agency does not have to appear in court and prove its case for issuing a civil investigative demand," according to Oberheiden & McMurrey. "To the contrary, authorities such as the U.S. Department of Justice have broad authority to issue civil investigative demands on their own accord."

False Claims Act claims can be expensive. In 2017, of course, eClinicalWorks agreed to pay  $155 million to settle FCA allegations related to meaningful use certification of its EHR technology. 

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com