OIG amends healthcare fraud self-disclosure protocol

HHS’ Office of Inspector General on Nov. 8 revised its protocol for self-disclosing healthcare fraud.

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The self-disclosure protocol allows healthcare organizations like hospitals and suppliers to voluntarily disclose self-discovered evidence of fraud. It allows these companies to avoid the costs associated with a government-directed investigation.

Here are five of the changes:

  1. Self-disclosure submissions must be made through the OIG’s website.
  2. The minimum amount required to settle under the self-disclosure protocol has increased to match new statutory minimum penalty amounts.
  3. CIA-reportable events can be disclosed under the self-disclosure protocol.
  4. The Justice Department sometimes settles self-disclosed cases. 
  5. Self-disclosures must include the damages to each affected federal healthcare program and the sum of all damages.

The OIG noted that several key items have not changed, including timelines and content requirements, a timely settlement with a lower multiplier and methods for calculating damages. 

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