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Self-disclosing potential liability issues

Compliance Monitor, May 5, 2006

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Q:We are a community hospital that has a compliance program. What is the appropriate way to self-disclose potential liability issues?

A:On April 24, 2006, Inspector General Daniel Levinson from the Department of Health & Human Services' Office of Inspector General (OIG) released "An Open Letter to Health Care Providers." The letter specifically references an OIG initiative to promote the use of the provider self-disclosure protocol (SDP). According to the letter, the OIG has heard from hospitals that have discovered improper arrangements under the Stark Law through their compliance program and are seeking ways to resolve a potential violation. The initiative is intended to resolve conduct that may result in a civil monetary penalty for Stark Law and Anti-Kickback Statute violations. Specifically, the initiative focuses on situations in which a hospital knowingly confers a financial benefit on one or more physicians.

The SDP initiative described in the open letter is intended to "serve as an additional opportunity for providers to work collaboratively with the OIG and to take responsibility for further strengthening the integrity of our healthcare system."

Depending on the alleged infraction, a variety of potential penalties, including fines and the imposition of a Certification of Compliance Agreement or a Corporate Integrity Agreement, can be imposed.

If a hospital believes it has potentially violated the Stark Law or the Anti-Kickback Statute, an experienced healthcare attorney should be contacted immediately to ensure that the scope of alleged violation is fully investigated before any further actions are taken.

Thanks to Bruce D. Armon, Esq., a partner with the Philadelphia-based law firm Saul Ewing LLP, for answering this week's question. Armon specializes in healthcare law and can be reached at barmon@saul.com.

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