OIG Releases Updated Self-Disclosure Protocol


On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released an updated Provider Self-Disclosure Protocol (Protocol) that supersedes and replaces the protocol published in the 1998 Federal Register and the Open Letters to Health Care Providers issued in 2006, 2008 and 2009.  In the updated Protocol, the OIG specifically highlights several benefits of self-disclosure, including the presumption against requiring integrity agreement obligations in exchange for a release of OIG’s permissive exclusion authorities, the ability to pay a lower multiplier on single damages than normally would be required in resolving a government-initiated investigation, and potential mitigation of exposure under the so-called “60 day overpayment rule,” which requires that a Medicare or Medicaid overpayment be reported and returned by the later of 60 days after the date on which the overpayment was identified, or the date any corresponding cost report is due. 

The OIG also provides new guidance on calculating multipliers, reporting conduct involving excluded individuals, and reporting potential violations of the Anti-Kickback Statute.  In addition to the updated Protocol, the OIG’s website indicates that a self-disclosure online form is “coming soon.”  A forthcoming King & Spalding Client Alert will provide an in-depth analysis of the Protocol and its implications for health care providers.  For a copy of the updated Protocol, please click here

Reporter, Kerrie S. Howze, Atlanta, +1 404 572 3594, khowze@kslaw.com.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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