The OIG's Revised and Expanded Self-Disclosure Protocol: Increased Transparency by the Government

On Apr 17, 2013, the Office of Inspector General (OIG) of the US Department of Health & Human Services released an updated self-disclosure protocol (SDP) that significantly overhauls the process for providers and others to voluntarily disclose and resolve instances of potential fraud involving federal health care programs such as Medicare and Medicaid. There are several benefits to using the SDP to disclose potential fraud. First, disclosing parties receive the benefit of a lower multiplier on single damages and a speedy resolution of liability -- especially when compared to often multi-year government investigations or whistleblower actions. Second, providers using the SDP can continue to expect that the OIG will not, as a matter of course, impose integrity measures as a condition for its exclusion release in settling the disclosed matter. Third, using the SDP may mitigate potential liability under the Affordable Care Act's 60-day overpayment provision. The new procedures discussed in the updated SDP are likely to be applied only prospectively.