Monday, April 24, 2006

DHHS OIG Issues Open Letter to Health Care Providers

Today the Office of Inspector General, United States Department of Health and Human Services, issued an Open Letter to Health Care Providers discussing the Inspector General's perspectives on compliance, the resolution of health care fraud cases, issuance of corporate integrty agreements (CIAs), and the OIG's Provider Self-Disclosure Protocol (SDP).

In addition, the letter announces an initiative promoting the use of the SDP to resolve civil monetary penalty (CMP) liability under the physician self-referral (Stark) and anti-kickback statutes for financial arrangements between hospitals and physicians. The range of CMP damages available goes from "number and dollar value of improper claims" under Stark to the "number and dollar value of improper payments or remuneration" under anti-kickback. The letter seems to indicate that the OIG will "settle the SDP matters for an amount near the lower end of the continum, i.e., a multiplier of the value of the financial benefit conferred by the hospital upon the physician(s)."

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