OIG should streamline Medicare's self-disclosed overpayment protocol, provider group says

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Federal officials need to provide clearer guidance and offer a more streamlined protocol for providers willing to self-disclose Medicare overpayments, a leading long-term care group says.

In recently released comments submitted to the Office of the Inspector General, the American Health Care Association wrote that while self-disclosures were originally intended to expedite resolution of potential fraud, the OIG's protocol “often are anything but ‘speedy,' even though OIG states that the SDP can ‘diminish the time it takes before the matter can be formally resolved.'”

Dianne J. De La Mare, AHCA's vice president of legal affairs, recommended that the OIG should clarify the types of disclosures appropriate for the OIG protocol and those that should be submitted to a provider's Medicare Administrative Contractor; establish a time frame for resolving a provider's disclosure; and clarify whether providers may face a CIA based on their disclosure.

Earlier this summer, Department of Health and Human Services Office of the Inspector General requested stakeholder comments regarding proposed revisions to its Medicare provider self-disclosure protocol.

Click here to read the AHCA's letter.

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