Practice Fusion, which offers free, ad-supported health records software to doctors, agrees to pay $145M DOJ fine for its role in boosting opioid prescriptions
- Practice Fusion ensured that addictive drugs were on the menu — 'It's evil. There's really no other word for it,' doctor says
BloombergEmma Court
Context & Ripple Effects
Practice Fusion built its business on a Faustian bargain: give doctors electronic health records for free, then monetize them through pharmaceutical advertising inside the clinical workflow. The DOJ's $145M settlement says that bargain crossed into illegality when the software was used to steer opioid prescribing. The company had already paid a market price for the model — once valued at $1.5B, it was acquired by Allscripts for just $100M two years before this fine.
The case lands amid a cluster of enforcement actions against health-tech companies accused of monetizing their position between patients, doctors, and drugmakers: the DOJ's fraud indictment of Outcome Health's founders over pharma advertising, GoodRx's FTC settlement over sharing intimate health data with Meta and Google, and the arrests at telehealth firm Done Global over an alleged Adderall prescription scheme.
First-order effects
Practice Fusion — now owned by Allscripts — writes a $145M check to the DOJ for conduct baked into the product before the acquisition, and inherits the reputational stain of a doctor quoted calling the behavior 'evil.'
Doctors who relied on the free system face renewed scrutiny of opioid prescriptions influenced by the software's prompts, and Allscripts must absorb liability for a product it bought at a steep discount.
Second-order effects
Every EHR vendor running ad-supported or pharma-funded clinical-decision content now faces the question regulators just answered: if your revenue depends on what drugs appear on the doctor's menu, you are a participant in prescribing, not neutral infrastructure.
Telehealth and digital-prescribing players like Done Global — already charged over Adderall practices — can expect prosecutors to apply the same theory upstream, to the software layer that shapes prescriber behavior.
Third-order effects
If the pattern holds, 'free' health software stops being a viable wedge: regulators are establishing that intermediaries sitting on the prescription pathway carry criminal liability for how they monetize it, forcing the industry toward transparent, paid licensing or heavily audited advertising.
The broader effect is a compliance tax on health-data and health-advertising startups — the GoodRx, Outcome Health, and Practice Fusion cases together signal that the FTC and DOJ will police the entire data-and-influence stack around prescribing, not just the drugs themselves.
The trend: US regulators are extending enforcement from drugmakers to the software intermediaries that sit between pharma money and the doctor's prescription pad, making monetization design itself a legal risk.
Remarkable. Electronic patient records systems used by thousands of doctors were programmed to automatically suggest opioids at treatment, thanks to a secret deal between the software maker and a drug company. @emmarcourt reports. https://www.bloomberg.com/... via @technology
New from DOJ: “Practice Fusion admits that it solicited and received kickbacks from a major opioid company in exchange for utilizing its EHR software to influence physician prescribing of opioid pain medications.” https://www.justice.gov/...
What an incredible scandal: A startup that makes medical records software used in tens of thousands of doctors offices was secretly getting paid by an opioid maker to insert a pop-up box suggesting opioid prescriptions https://www.latimes.com/... https://twitter.com/...
Everyone who worked on this should be in jail. From management, to strategy, to design, to engineering. Not only did they betray the people they're supposed to look out for, they did it while those people were seeking care. They knew what it did and they built it. Shame on them. …
Practice Fusion, a SF-based electronic health-records maker, made a secret deal to nudge doctors to prescribe more opioids. Pharmaceutical company paid just $1m for a program that ensnared over 3,000 victims, many of whom may well have become addicts. ☠️ https://www.bloomberg.com…
It's been a while since I just stared at a screen shocked by a product decision. I'd never heard of @practicefusion before today but it'll be part of case studies for the next 50 years. https://twitter.com/...
Somewhere, sometime an engineering team coded this feature. It was a ticket with a user story, talked about in a standup, work tracked in an jira or something similar. When in that process did someone say “hey, is this ethical? Is this legal?” https://twitter.com/...
Sickening: “Between 2014 and 2019, health care providers using Practice Fusion's EHR software wrote numerous prescriptions after receiving CDS alerts that pharmaceutical companies participated in designing.” https://twitter.com/...
This is a shocking story—and the fact that this practice went on until 2019, years after the opioid crisis had become a full-blown national crisis, make it even more scandalous. https://www.bloomberg.com/... via @technology
Free dosage determination medical software was coded to over-prescribe opioids to benefit pharma. Oops. https://www.washingtonpost.com/ ... But I'm sure that artificial intelligence systems used to make decisions will be entirely objective.
This is outrageous and the people involved should be in prison. It's also what happens when you combine profiteering and healthcare #m4a https://www.washingtonpost.com/ ...
oh my god An electronics medical record company accepted kickbacks from drug companies to *code in preference for their opioids*! https://www.justice.gov/... https://twitter.com/...
To doctors opening patients' electronic records across the U.S., the alert would have looked innocuous enough. But behind the tool was a secret deal cut with a major opioid manufacturer — even as the U.S. opioid crisis raged. https://www.bloomberg.com/...
Astounding: an electronic medical record company solicited kickbacks from opioid manufacturers in return for tweaks to its records that would encourage more opioid prescribing — at the height of the opioid epidemic. https://www.justice.gov/...
I can't get over how terrible this is. EMR vendor took money from an opioid maker to add an alert to increase opioid prescriptions. Fine is more than Allscripts paid for Practice Fusion, the company in question. https://www.justice.gov/...