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Update to Fraud Self-Disclosure Rules for Regulated Healthcare Entities Blog Corporate Deal Source

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On November 8, 2021, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued an update to the Health Care Fraud Self-Disclosure Protocol (SDP). This update revises and renames the Provider Self-Disclosure Protocol last updated by OIG in 2013. The changes are mostly procedural in nature and update the SDP based on legislative adjustments to penalty amounts.

IN DEPTH

OIG recently posted revisions to the SDP, which was first published in the 1998 Federal Register as a process through which healthcare providers, suppliers and other entities subject to civil monetary penalties can voluntarily self-disclose matters involving potential fraud stemming from participation in federal healthcare programs. Pursuant to the SDP, examples of what can be appropriately disclosed include, but are not limited to, submissions of improper claims to federal healthcare programs, potential violations of the federal Anti-Kickback Statute and the physician self-referral law (otherwise known as the Stark law), and employment or contracting with excluded individuals on OIG’s List of Excluded Individuals and Entities.

The SDP’s goal is to facilitate compliance with federal healthcare program requirements by offering entities subject to civil monetary penalties the opportunity to make good faith disclosures of potential fraud and avoid […]

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