OIG Self Disclosure Protocol – OIG Explains at HCCA Conference

An OIG representative spoke about the new revised self disclosure protocols at a recent HCCA seminar that I attended.  The OIG felt it was appropriate to be more transparent regarding the process for self disclosure.  A few points were highlighted in this session:

1. The OIG held its own feet to the fire by acknowledging the 1.5 damage multiplier when the self disclosure protocol is used.  They will need to justify if they are going to ask for more.
2. Self disclosure is not an admission of liability.  However, you will be required to make a settlement and payment if you make a self disclosure.
3. Self disclosure is not to be used to get an interpretation of whether your activity was wrongful or whether a law was violated.
4. A decision not to self disclose leaves you open to potential whistle-blower complaints.  False Claims Act potential remains for the ten-year False Claims Act statute of limitation.
5. Repayment can go to the fiscal intermediary if there is no wrongdoing but there is still an overpayment.
6. Self disclosure requires disclosure of how your investigation was conducted.  If the investigation was conducted under privilege, you will need to disclose privileged information on investigation under privilege.
7. The only party that can give you a False Claims Act release is the Department of Justice.

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Tags: Medicare Disclosure, OIG Self Disclosure, provider self disclosure, Self Disclosing

This entry was posted on Tuesday, April 8th, 2014 at 8:19 am and is filed under Fraud and Abuse, OIG Annual Work Plan, Safe Harbor Regulations, Self-Disclosure. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.