Why They Self Disclosed

Posted by Frank Strafford on July 20, 2015 in Industry News, Self Disclosure,

Of all the penalties issued this year by the OIG in response to healthcare organizations that employed excluded individuals, all but three were the result of self-disclosures.

Provider Self-Disclosure ProtocolWhich kind of makes you wonder: Why?  Why would a healthcare organization go ahead and self-disclose, knowing that it will almost definitely be hit with a fine worth tens or even hundreds of thousands of dollars?

The answer is even simpler than the question.

Because not self-disclosing can be much, more worse.

According the OIG’s recently released Fiscal Year 2015 HHS OIG Work Plan Mid-Year Update, 4,017 individuals and entities were excluded from participation in Federal health care programs in 2014 alone.  That’s a lot of exclusions to keep track of; but there’s more.

The update goes on to describe its Provider Self-Disclosure protocol as follows:

The Provider Self-Disclosure Protocol gives providers an opportunity to minimize the potential costs and disruption that a full-scale OIG audit or investigation might entail if fraud is uncovered. The self-disclosure also HHS OIG Work Plan Mid-Year Update | FY 2015 CMS-Related Legal and Investigative Activities enables the provider to negotiate a fair monetary settlement and potentially avoid being excluded from participation in Federal health care programs. (emphasis added)

In other words, healthcare organizations that do not self-disclose can be hit with something a lot worse than fines — they can be excluded from participation in Federal health care programs altogether.

Oh.  So that’s why.

 

About Frank Strafford

About Frank Strafford

Related Articles

MANAGING THROUGH AN EXCLUSION BY THE ...

June 1, 2021

AN OVERVIEW of THE OIG’S LIST OF EXCLUDED INDIVIDUALS AND ENTITIES Since 1977, the federal government has maintained a list of individuals and entities that are excluded from participation in any...

Regards from HCCA’s 19th Annual ...

April 21, 2015

The HCCA's 19th Annual Compliance Institute is keeping us pretty busy!  Here are a couple of eye-openers from the experience: There's a lot to learn.  Compliance law is constantly changing.  Ke...

The NPI Registry and Why It ...

December 12, 2016

Technological Numbers What is an NPI Number? National Provider Identifiers (NPIs) were created to ensure for accuracy and efficiency in the health care system when it comes to transmitting informati...

Understanding OIG Exclusions

OIG Exclusions Screening Process

Exclusion FAQS

Quick OIG Exclusion Basics

Employing Excluded Individuals

Consequences to Employing an Excluded Individual

OIG Compliance Law

Laws and Publications on OIG Compliance

More Compliance Resources

Our Culture

We build the best, so you can perform at your best.

Trusted for Good Reason

  • ✓ Guaranteed accurate
  • ✓ Certified Secure
  • ✓ Audit Proof
  • ✓ Feature-rich reporting
  • ✓ Round the clock real-time-data
  • ✓ Processing fully automated

Security First

  • ✓ Cloud hosted
  • ✓ Encrypted data
  • ✓ Real-time backups

Trusted for Accuracy

  • ✓ Physical security
  • ✓ Restricted access
  • ✓ Single sign-on
  • ✓ Password security
  • ✓ Certified secure
  • ✓ Cross checking

HEALTHCARE ESTABLISHMENTS NATIONWIDE COUNT ON STREAMLINE VERIFY

5

60%

Average workload reduction by implementing the Streamline Verify program

5

10K

Establishments trust Streamline Verify nationwide

5

2011

Serving the healthcare industry’s unique compliance needs since 2011

5

24X

Setting standards with hourly synchronization to primary source data