But why would any healthcare company turn itself in at all, let alone press the new red button to start the turning-yourself-in process online?
The upside is, entities that self-disclose unlawful conduct become eligible for deep discounts on potential penalties, though the OIG doesn't have final say over penalties in all cases. Any organization or individual that has been on the receiving end of a Stark or False Claims investigation knows how rapidly dollar figures can climb into the millions when the potential damages are multipliers of the amount of money generated by an illegal compensation arrangement with a physician. (Tally up every Medicare payment involving a cardiologist with a below-market-rate office lease for a period of two years, and multiply it by two or three, depending on the severity.)
In a revamped manual released in April (PDF) regarding its self-disclosure program, the OIG acknowledged publicly for the first time that most first-time offenders in the program will have to pay back only 150% of the value of all the claims tainted by an illegal arrangement. Agency officials said self-disclosing businesses typically avoid the penalty of having an embarrassing and burdensome corporate integrity agreement imposed on them.
The online description of the program also contains a caveat that says OIG is subject to public information requests through the Freedom of Information Act, and that any part of a disclosure that contains trade secrets or privileged information should be clearly noted.
The OIG's self-disclosure program is not open to pure Stark violations, which tend to be less severe and don't implicate other laws. Those disclosures have to go to the CMS' separate (and very backlogged) Stark disclosure program.
The link to the Stark disclosure program is here.
Just as OIG doesn't have jurisdiction over those less-severe cases that implicate only Stark, the office also lacks authority to resolve many of the most serious cases, which are those involving the False Claims Act. Only the Justice Department can waive potential civil or criminal liability under the false claims law. In those cases, the OIG promises to work with Justice officials and advocate on behalf of the healthcare company for lower punishments in exchange for self-reporting violations.
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