Optional_2023 Board Resources

overpayment through the OIG’s SDP, then the provider is “considered to be in compliance” with the 60-day overpayment rule. 65 (iv) Timely Resolution . On average, OIG resolves cases within 12 months of acceptance into the SDP. (b) Eligibility . All providers subject to OIG’s CMP authorities are eligible to participate in the SDP with respect to their own potential liability. The SDP should not be used to report the conduct of others; rather, providers should use OIG’s hotline to report the conduct of others. 66 Furthermore, potential liability under the Stark law should be carefully distinguished from potential liability under the AKS; if the liability is exclusively under the Stark law, then the provider cannot use OIG’s SDP and should participate in CMS’s Voluntary Self-Referral Disclosure Protocol (SRDP) as discussed in Section 2.2 above. (c) General Requirements . There are specific disclosure requirements for conduct involving (x) false billing, (y) excluded persons, and (z) the AKS and Stark law. 67 However, all submissions to the SDP must include: 68 (i) The name, address, type of health care provider, provider identification number(s), and tax identification numbers(s) of the disclosing party and the Government payors to which the disclosing party submits claims (or a statement that the disclosing party does not submit claims); (ii) If the disclosing party is an entity owned by, controlled by, or otherwise part of a system or network, then such party must provide an organizational chart, description, or diagram outlining the pertinent relationships. Such party must include the names and addresses of any related entities and any affected corporate divisions, departments or branches; (iii) The name, street address, phone number, and email address of the disclosing party’s designated representative for purposes of the voluntary disclosure; (iv) A concise statement of all details relevant to the conduct disclosed, including the type of conduct giving rise to the matter, the period during which such conduct occurred, the names of entities and individuals involved, and an explanation of such entities’ or individuals’ roles in the conduct; (v) A statement of the federal criminal, civil, or administrative laws that are potentially violated by the disclosed conduct; 65 “Medicare Reporting and Returning of Self-Identified Overpayments,” Centers for Medicare and Medicaid Services: U.S. Department of Health and Human Services , available at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-02-11.html (last accessed August 29, 2017). 66 “Provider Self-Disclosure Protocol” at *3. 67 Id at *7-11. 68 Id at *5.