Are You Aware of the Updated CMS Timeline for Meaningful Use?
Is your staff practicing hand hygiene that complies with your policies and procedures?

Just correct the problem and you will be compliant?
No, but this is the first step in the right direction.

According to the HHS in “A Roadmap for New Physicians – Avoiding Medicare and Medicaid Fraud and Abuse,” the following steps should be taken:

  • Immediately cease filing the problematic bills
  • Seek knowledgeable legal counsel
  • Determine what money you collected in error from your patients and from the Federal Healthcare programs and report overpayments
  • Consider following OIG Provider Self-Disclosure Protocol
  • If using the Provider Self Disclosure Protocol, provider should place presumed overpayment amount in an interest bearing escrow account during OIG inquiry

The Provider Self Disclosure Protocol (SDP) gives the providers the opportunity to voluntarily disclose potential fraud. The OIG considers this transparency, which may avoid significant costs associated with a government investigation and litigation.

The OIG will not accept any payments of presumed overpayments until their investigation is complete. If the OIG agrees to a request by the provider to make a payment to the Federal Healthcare programs or contractors regarding the disclosed overpayment, the provider must agree in writing that this does not constitute the Government’s agreement as to the amount of losses suffered by the programs and does not affect the Government’s ability to add fines, damages or penalties.

The provider’s good faith cooperation with the OIG throughout the entire process will hopefully resolve any potential physician liabilities.

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