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Tuesday, October 1, 2013

Providers Increasingly Self-Disclosing Overpayments

by James Swann

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Voluntary self-disclosures of overpayments are up as providers look to avoid government action, a DOJ official said at a conference I attended Monday. Margaret Hutchinson, chief of the civil division of the U.S. Attorney's Office for the Eastern District of Pennsylvania, said providers are worried that whistle-blowers will report an overpayment to the government, and are heading them off at the pass by self-disclosing. Hutchinson spoke during the morning session of the AHLA/HCCA Fraud & Compliance Forum in Baltimore.

Hutchinson said the rise in voluntary self-disclosures is due in part to changes the Affordable Care Act made to the False Claim Act, namely creating FCA liability for the retention of any overpayments. In addition, the ACA said providers must return overpayments to the government within 60 days of identifying them, or face action. Marilyn May, an attorney with Arnold & Porter who also spoke at the conference, said voluntary self-disclosures allow providers to frame an issue instead of letting the government dictate the course of events.
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