Archives: Self-Disclosure

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OIG updates policy regarding gifts of nominal value

On Dec. 7, 2016, the U.S. Department of Health & Human Services Office of Inspector General (OIG) released an update to its 2000 policy regarding gifts of nominal value given to a Medicare or Medicaid beneficiary. The update increases the nominal value of gifts given to a Medicare or Medicaid beneficiary to $15 per occurrence … Continue Reading

Unique Considerations in Healthcare M&A Part 1 – Due Diligence

Due diligence is often perceived as a mundane part of the mergers & acquisitions (M&A) process, but its importance in healthcare transactions is critical. Due diligence is one of the first steps of any transaction and involves a buyer undertaking an in-depth examination of the target to evaluate the business and uncover potential issues or … Continue Reading

Jury Returns Landmark Verdict in Tuomey Case

The jury in the Tuomey case (U.S. ex rel. Drakeford v. Tuomey Healthcare Systems, Inc.) returned a verdict in favor of the government yesterday, May 8, 2013.  As is well known, this is the re-trial of a case centered on a series of employment agreements that Tuomey Healthcare entered to allegedly capture referrals from a … Continue Reading

Office of Inspector General Issues Updated Self-Disclosure Protocol

On April 17, 2013, the Office of Inspector General (OIG) updated the OIG’s self-disclosure protocol (SDP).  This update significantly revises the SDP first published in 1998, and supersedes the OIG’s related open letters to providers from 2006, 2008 and 2009. To date, the OIG has processed 235 settlements and monetary recoveries in excess of $280 … Continue Reading

OIG Projects $6.9 Billion in Recoveries From Audits and Investigations

In its Semi-Annual Report to Congress, OIG announced that expected recoveries for FY 2012 are $6.9 billion.  The $6.9 billion consists of $923.8 million in audit receivables and $6 billion in investigative receivables.  The investigative receivables include criminal restitution, settlements pursuant to False Claims Act (FCA) cases and Civil Monetary Penalty (CMP) actions, and other … Continue Reading

Chief Counsel to OIG Says It Will Update Guidance for Entities

At a recent conference, Greg Demske, the new Chief Counsel to the OIG, said that his office will be issuing new guidance explaining how OIG will resolve cases where an entity hires or contracts with an excluded individual.  Given that the last guidance on this topic was issued in 1999, this should be a welcome … Continue Reading

Husch Blackwell Attorneys Discuss The Stark Law and Self-Disclosure

On September 25, 2012, two members of the Husch Blackwell Healthcare team, Brian Bewley and David Pursell, presented a webinar discussing: An overview of Stark Stark overpayment reporting requirements Steps to take after discovering a potential Stark violation As former Senior Counsel in the Office of Inspector General for Health and Human Services and a … Continue Reading

OIG-HHS Seeking to Improve Self-Disclosure Protocol

On June 18, 2012, the Office of Inspector General for the Department of Health and Human Services (OIG) published a notice in the Federal Register seeking comments and recommendations on how best to revise its self-disclosure protocol to make it more useful in today’s health care regulatory environment. This should come as welcome news to … Continue Reading

Healthcare Boards of Directors Should Take Note of Glaxo's Settlement

Another major drug company agreed to settle with the Department of Justice (DOJ). GlaxoSmithKline LLC (GSK) agreed to pay a historic $3 billion and plead guilty to resolve its alleged criminal and civil liability arising from the company’s promotion of certain prescription drugs, failure to report certain safety data, and its civil liability for alleged false price reporting … Continue Reading