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Wednesday, October 10, 2012

When In Doubt, Self-Disclose

by James Swann

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With providers facing increasing penalties for Medicare and Medicaid program violations, self-disclosure is on the rise, an OIG official said at a recent conference I attended. Tony R. Maida, a deputy chief in the administrative and civil remedies branch of the OIG's Office of Counsel, said that providers who self-disclose potential violations can receive lower penalties and also avoid having to enter a corporate integrity agreement. Maida, who was speaking at the 2012 Fraud and Compliance Forum, jointly sponsored by the American Health Lawyers Association and the Health Care Compliance Association, also said providers who self-disclose have more control over their dealings with the government, as opposed to a situation where the government initiates the investigation.

Maida was joined by Joseph C. Hudzik, deputy director of CMS's Division of Technical Payment Policy, who addressed the CMS self-referral disclosure protocol. Hudzik said the protocol applies to potential violations of the physician self-referral law, or Stark law, and he said provider submissions have grown from 36 in 2010, the protocol's first year, to 104 in 2011. Hudzik said CMS has received 73 submissions so far in 2012.
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