HHS-OIG Launches On-Line Platform to Submit Self-Disclosures

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Earlier today, the OIG launched an online submission process for its voluntary Self-Disclosure Protocol. This online disclosure tool is designed to make it even easier for providers who wish to voluntarily disclose self-discovered evidence of potential fraud to OIG. According to the OIG’s associated press release, “Self-disclosure gives providers the opportunity to avoid the costs and disruptions associated with a Government-directed investigation and civil or administrative litigation.” As a practical reality, voluntarily disclosing compliance irregularities to OIG can have a number of positive benefits, but the decision can also have significant negative repercussions and should only be done after comprehensively analyzing the situation with the assistance of competent counsel.

The OIG’s decision to implement online submissions follows on the heels of its general update of the SDP on April 17, 2013, which was the first time the protocol had been updated in fifteen years. As self-described, the OIG updated the SDP to provide disclosing parties with a better understanding of the relevant time frames, requirements for complete disclosure and potential post-disclosure resolutions, and to streamline and expedite the SDP process. More specifically, the updated SDP largely reaffirmed many of the OIG’s historical positions regarding voluntary disclosure, and it served to provide a formal written statement of these positions and provide some additional changes. For example, the new SDP includes specific requirements for disclosure and investigation of conduct involving (1) false billing, (2) employment of, or contracts with, Excluded Individuals or Entities, and (3) the anti-kickback statute. It also requires that disclosing providers complete internal investigations and damages assessments within 90 days from the “initial submission” (as opposed to the formerly utilized deadline of “within 3 months of acceptance” into the SDP). The update also clarified that the OIG will generally require a minimum multiplier of 1.5 times the single damages as a condition of settlement, although the OIG did recognize that a given provider’s ability to pay could be considered. For hospitals, physicians and all healthcare providers, the SDP reinforces the need for a robust compliance program, and the attorneys at Nicholson & Eastin stand ready to assist with the evaluation of any suspected compliance concerns and disclosure obligations.