Healthcare Providers and Voluntary Disclosures

Evaluating If, When and How to Report to CMS, DOJ or OIG

OIG's rejection of Stark violation reporting alters self-disclosure landscape

Recording of a 90-minute CLE webinar with Q&A


Conducted on Thursday, November 5, 2009

Recorded event now available

or call 1-800-926-7926
Program Materials

This seminar will discuss the Office of Inspector General (OIG) Open Letter and its impact on self-disclosure of violations for healthcare providers. The panel will outline strategies for healthcare providers and counsel in deciding if, what, when and how to report potential violations.

Description

Enforcement against healthcare fraud and abuse is an Obama administration top priority, as demonstrated by changes to the False Claims Act and increased funding for fraud and abuse prevention. Violations can involve anything from simple error to intentional fraud.

In March, the Office of Inspector General (OIG) made a dramatic change to its self-disclosure protocol (SDP), which has left healthcare providers with a lot of questions. The OIG Open Letter announced the OIG will no longer accept self-disclosure of Stark law violations under its SDP.

Healthcare providers must now evaluate their potential violations to determine whether, how and to whom to report. Providers must implement a whistleblower process so they can investigate areas of concern and determine if there are violations that require self-disclosure.

Listen as our authoritative panel of healthcare attorneys examines the revised OIG self-disclosure protocol, discusses how to report Stark law and other violations, and offers best practices for both addressing potential violations and using OIG protocol.

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Outline

  1. The Law Of Overpayments and Self-Disclosure
    1. Types of Overpayments and Defenses
    2. Special Stark Law Issues
    3. Enforcement Statutes
  2. Practical and Strategic Considerations and Best Practices
    1. Conducting the Investigation
    2. Handling Potential Whistleblowers
    3. Determining What to Disclose and How
    4. Dealing With Missing Evidence and Witnesses
    5. How Far Back?
    6. Internal Communications and Informing the Board
  3. Voluntary Disclosure Options
    1. OIG self-disclosure protocol
    2. Department of Justice
    3. Medicare Contractors
    4. State voluntary disclosure protocols
    5. Stark Law and Self-Disclosure
    6. Self-Disclosure Case Studies
    7. Is Self-Disclosure A Defense?

Benefits

The panel will review these and other key questions:

  • How does the OIG's Open Letter alter the approach of a healthcare provider undertaking voluntary disclosure?
  • What options do healthcare providers have for voluntary disclosure after the Open Letter?
  • What factors should healthcare providers consider when determining whether a potential violation should be reported?
  • If a healthcare provider reaches settlement with the Department of Justice, what impact will that settlement have on the provider's dealings with OIG? Or with the Centers for Medicare and Medicaid Services?

Faculty

Witten, Jesse
Jesse A. Witten

Partner
Drinker Biddle & Reath

Mr. Witten counsels on health law issues, including Medicare and Medicaid reimbursement and price reporting...  |  Read More

John E. Steiner, Jr.
John E. Steiner, Jr.
Chief Compliance Officer
UK HealthCare, University of Kentucky

He is responsible for the design, implementation, and oversight of an enterprise wide compliance program encompassing...  |  Read More

Paul M. Danello
Paul M. Danello

Partner
Baker and Daniels

He has over 30 years experience in healthcare law and concentrates in corporate, financing and government regulatory...  |  Read More

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