HHS OIG Updates the Health Care Fraud Self-Disclosure Protocol

24
Gil C | Shutterstock

Today, the Department of Health and Human Services Office of Inspector General released an update to the Health Care Fraud Self-Disclosure Protocol (SDP). Established in 1998, the SDP can be used by health care providers, suppliers, or other individuals or entities subject to Civil Monetary Penalties to voluntarily disclose self-discovered evidence of potential fraud.

The portal has been updated to:

  • Increase the minimum amounts required to settle under the SDP to match new statutory minimum penalty amounts
  • Require SDP submissions to be made through HHS OIG’s website
  • Add references to OIG’s 2019 Grant and Contract Self-Disclosure Protocols
  • Clarify that CIA Reportable Events can be disclosed under the SDP
  • Clarify that DOJ sometimes settles SDP cases
  • Clarify that disclosures must include damages to each affected federal healthcare program and the sum of all damages
  • Make technical changes to statistics, terminology, and background facts.

The update made no changes to the timeline and content requirements of disclosures; the methods for calculating damages; or the approach of timely settlements with a lower multiplier and an exclusion release.

View the portal here.