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OIG Solicits Comments Regarding Revision to Self-Disclosure Protocol

Posted in Department of Health and Human Services, Fraud and Abuse

On June 18, the OIG published notice in the Federal Register advising that it is now soliciting information and recommendations for revising its provider self-disclosure protocol. [https://www.federalregister.gov/articles/2012/06/18/2012-14585/solicitation-of-information-and-recommendations-for-revising-oigs-provider-self-disclosure-protocol#p-13]

The OIG’s self-disclosure protocol is a mechanism whereby providers may voluntarily disclose self-discovered evidence of potential violations of the Anti-Kickback Statute.  Providers utilizing the protocol must disclose a description of the conduct being disclosed, a description of the provider’s internal investigation of the matter, an estimate of damages to the Federal health care programs and a statement of laws potentially violated by the conduct.  While the OIG is not bound by the disclosing provider’s assessment of its liability, the goal of the protocol is to provide a system where the OIG and the provider can work together to resolve potential violations quickly and efficiently.  Currently the protocol is only available for matters of at least $50,000.

The OIG is currently soliciting comments and recommendations for revisions to its self-disclosure protocol.  The request appears to be broad, allowing commenters to submit on virtually any topic relevant to the protocol.  Some issues to be considered may be (i) the interplay of the protocol with the new 60-day overpayment refund requirement ; (ii) the level of knowledge of potential fraud required before utilizing the protocol; and (iii) establishment of set timeframes for resolving disclosed matters.   Comments must be provided by 5 p.m., August 17, 2012.