Foley & Lardner LLP Partner Lori Rubin is quoted in a Healthcare Risk Management article titled, “Reporting Misdeeds: How and When to Use Disclosure Protocol,” which discusses the primary routes for self-disclosure of health care fraud.
The Department of Health and Human Services Office of Inspector General (OIG) updated its Provider Self-Disclosure Protocol in November 2021 and changed the name to the Health Care Fraud Self-Disclosure Protocol (SDP). Most of the changes were technical, but the update provides an opportunity for health care risk managers to review the protocol and understand how to implement it when necessary.
Rubin notes that "In addition to disclosing through the OIG-SDP, health care organizations can disclose directly to the Department of Justice (DOJ). This requires a very careful consideration of whether to disclose, what to disclose, and where to disclose. You have to consider a lot of factors, including the complexity of the health care issues." She adds, "An internal investigation is the first step to determining whether to report and how."