The Department of Health and Human Services capped off a week of intensive anti-fraud activity with the launching of a six-month healthcare False Claims Act self-disclosure pilot program in partnership with the Department of Justice’s Civil Division.
“Companies that identify and report potential violations should have a clear way to correct them, repay the government, and continue serving people in federal healthcare programs,” Centers for Medicare & Medicaid Services Administrator Mehmet Oz, MD, said in a statement on Thursday. “This pilot creates a defined path to accountability while helping CMS focus its enforcement resources on fraud.”
To participate, companies must disclose all relevant details about the potential violations, provide documents showing the full nature and operation of the conduct, describe the remedial steps they have taken, and make a repayment calculated under the protocol.
In exchange, companies will receive a release from DOJ for the disclosed potential False Claims Act violations, the HHS Office of Inspector General will not impose an exclusion or require a Corporate Integrity Agreement as part of the resolution, and CMS not revoke the provider’s or supplier’s enrollment and billing privileges, and neither CMS nor OIG will impose civil monetary penalties.
The protocol applies a multiplier of 1.25 to 1.6 to the repayment. The multiplier will vary based on factors such as the timeliness of the disclosure, the duration and scope of the...
The Department of Health and Human Services capped off a week of intensive anti-fraud activity with the launching of a six-month healthcare False Claims Act self-disclosure pilot program in partne...