United States HHS OIG Reviewing Self Disclosure Protocol for Federal Health Care Programs

The federal government’s Office of the Inspector General (“OIG”), part of the United States Department of Health and Human Services, is considering revising its self-disclosure protocol to provide additional guidance to federal health care program providers.  The OIG is soliciting comments from all sources on the process by which health care providers can report overpayments and potential fraud.

The current OIG self-disclosure protocol was issued in 1998 and is available here.  The OIG Provider Self-Disclosure Protocol established the process by which providers self-reported overpayments and potential fraud thereby satisfying their obligation to do so under federal law.

According to the OIG, it has resolved more than 800 disclosures in the past 14 years yielding more than $280 million in recoveries.

The current OIG Protocol provides guidance on how to investigate conduct, quantify damages, and report the conduct to OIG to resolve the provider’s liability exposure under OIG’s civil money penalty authorities.

The OIG will accept comments on the protocol until August 17, 2012.

Read more about this at the Federal Register here.

Comments on the protocol may be submitted three ways:

(1)           electronically via the Federal eRulemaking Portal at http://www.regulations.gov;

(2)           via regular, express, or overnight mail to the following address: Kenneth D. Kraft, Office of Inspector General, Department of Health and Human Services, Attention: OIG-1301-N, Room 5541B, Cohen Building, 330 Independence Avenue SW., Washington, DC 20201 (please allow sufficient time for mailed comments to be received before the close of the comment period); or

(3)           via hand or courier before the close of the comment period to Kenneth D. Kraft at the address above.

All comments and submissions must include the agency name and docket number, and all comments, including attachments and other supporting material received, are subject to public disclosure and inspection.

For more information, please contact the author, David R. Ross, Esq.


David Ross

About David Ross

David is Partner and concentrates his practice on Medicaid, Medicare and private insurance audits & investigations, Health Law including fraud and abuse, governmental investigations of all kinds, Medicaid compliance plans and Article 78 cases. He is head of our Government Investigations practice and also works in Healthcare Fraud & Abuse.