OIG to change provider self-disclosure protocol

After more than a decade of resolving self-disclosures, the Office of the Inspector General will revise its self-disclosure protocol and is soliciting comments from the public on how hospitals and other providers can self-report possible healthcare fraud, OIG said in a Federal Register notice yesterday.

In October 1998, the Provider Self-Disclosure Protocol established a process for providers to report possible fraudulent activity, therefore allowing a way for providers to resolve their liability exposure under the OIG's civil money penalty authorities.

For example, Tenet Healthcare Corporation discovered it overbilled Medicare for more than two years at 25 Tenet inpatient rehabilitation units. When it discovered the overpayments through an internal 2007 review, Tenet's compliance department "promptly notified the OIG of its findings," as required by self-disclosure regulations, it said in April. The health system paid $42.75 million to settle allegations that it violated the False Claims Act.

OIG has resolved more than 800 disclosures in the past 14 years, resulting in more than $280 million recoveries, according to the Federal Register notice.

OIG will accept comments until August 17.

For more information:
- see the Federal Register notice
- check out the current self-disclosure website and October 1998 rule (.pdf)

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