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
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 Emma Court / @emmarcourt : 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/... Drew Armstrong / @armstrongdrew : An electronic records company, used by doctors, admits that it TOOK KICKBACKS to INCREASE OPIOID PRESCRIPTIONS. https://www.justice.gov/... Joshua Topolsky / @joshuatopolsky : This is some of the dirtiest shit I've ever heard of in my life https://www.inputmag.com/... Sarah Kliff / @sarahkliff : 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/... Matthew Herper / @matthewherper : 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/...
BloombergEmma Court
Context & Ripple Effects
Practice Fusion built its business on a seductive pitch: free, ad-supported electronic records for doctors, with pharma paying to reach them. The DOJ's $145M settlement reveals what that model could hide — clinical alerts inside the software that were actually paid placements from an opioid manufacturer, running until 2019, deep into the crisis. The company had already been marked down once: after a $1.5B valuation and $157M+ raised, Allscripts bought it for just $100M in early 2018, while this conduct was still ongoing.
The settlement lands in a stretch where enforcers have been working through digital health's intermediaries one by one — the Outcome Health founders' fraud indictment over pharma advertising, GoodRx's FTC settlement over sharing health data with Meta and Google, and later the Done Global arrests over Adderall prescriptions. Practice Fusion is the case that shows the risk sits not just in adtech or telehealth but in the clinical workflow itself.
First-order effects
Allscripts, which absorbed Practice Fusion in its 2018 acquisition, now owns both the $145M payment and the reputational liability for conduct that predated and continued past the deal.
Practice Fusion's core go-to-market — free software funded by pharmaceutical money reaching doctors at the point of prescribing — is effectively dead as structured, since the DOJ has priced that channel as a kickback scheme.
Second-order effects
Every health-IT vendor monetizing pharmaceutical relationships through EHR prompts, ads, or data sharing faces pressure to disclose and restructure those deals before prosecutors set the terms for them.
Buyers of health-IT assets inherit enforcement exposure along with the codebase, which should depress prices for distressed digital-health companies whose revenue depends on drugmaker spending — a dynamic already visible in Practice Fusion's own fire-sale valuation.
Third-order effects
If the pattern holds across Outcome Health, GoodRx, Done Global, and Practice Fusion, the software layer between doctors and drugmakers becomes a standing enforcement target, forcing 'free' health tools toward transparent, auditable revenue models or direct customer payment.
Clinical decision tools — the alerts and prompts doctors see as neutral — will likely face demands for provenance and disclosure of who paid for them, making the funding trail part of the product's regulatory surface.
The trend: US regulators are systematically dismantling the opaque commercial plumbing of digital health — kickbacks, ad placements, and data flows between software vendors and drugmakers — case by case.
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/...
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/...
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
DOJ announcement of the settlement is just wild: “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/...
A fine? How about prison time for all the execs and a distribution fo ALL THEIR MONEY to victims (i get that the logistics are diabolical but c'mon!). https://twitter.com/...
Also, again, reminder that this startup was backed by who's who of vulture capital: Thiel's Founders Fund, Kleiner Perkins, and a laundry list of other accessories to this addiction kick-back scheme. Disgusting.
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/...
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/...
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
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/...