The Office of Inspector General (“OIG”) of the United States Department of Health and Human Services recently updated its Provider Self-Disclosure Protocol, which establishes a procedure for health providers to voluntarily disclose instances of potential fraud involving federal health care programs. Originally published in 1998, this process has resulted in the recovery of over $280 million for the benefit of U.S. taxpayers.
After analyzing the procedure and receiving input from the health care community regarding ways it could be improved, OIG has chosen to revise the Self-Disclosure Protocol in its entirety.
In announcing the revised Self-Disclosure Protocol, OIG emphasized that members of the health care industry have a legal and ethical duty to act with integrity when dealing with the federal health care programs. This duty includes an obligation to take appropriate steps to detect and prevent fraudulent and abusive activities, to implement specific procedures and mechanisms to investigate and resolve instances of potential fraud involving the federal health care programs, and to make full disclosure to the appropriate authorities.
Providers who disclose potential fraud and cooperate with OIG’s investigation are usually not required to adopt integrity agreement obligations, in large part because OIG considers these good faith disclosures to be indications of an effective compliance program. Additionally, providers who voluntarily disclose these issues typically pay less in civil penalties than those who remain silent until the government initiates an investigation.
For more information on the new Self-Disclosure Protocol, click here:
https://oig.hhs.gov/compliance/self-disclosure-info/files/Provider-Self-Disclosure-Protocol.pdf