Health Care Self-Disclosure: Everything You Need to Know to Successfully Navigate the Self-Disclosure Process


CLE Credits earned: 2 GEN

Attorneys attending this CLE can expect to receive an in-depth overview of the process for self-disclosing potential violations of federal and state health care fraud and abuse laws to the appropriate agencies. The program will include (1) an overview of the laws that may require self-disclosure by providers, including the Anti-Kickback Statute, the False Claims Act, the Stark Law, and more; (2) the process for determining when self-disclosure is appropriate; (3) how to determine the appropriate agency for self-disclosure; and (4) the process for self-disclosing to the appropriate agency.

Key topics to be discussed:

• Overview of the Federal Health Care Fraud and Abuse Laws
• The 60-Day Overpayment Rule
• The OIG Self Disclosure Protocol and the CMS Self-Referral Disclosure Protocol

Date / Time: October 8, 2018

•   2:00 pm – 4:00 pm Eastern
•   1:00 pm – 3:00 pm Central
•   12:00 pm – 2:00 pm Mountain
•   11:00 am – 1:00 pm Pacific

Choose a format:

•   Live Video Broadcast/Re-Broadcast: Watch Program “live” in real-time, must sign-in and watch program on date and time set above. May ask questions during presentation via chat box. Qualifies for “live” CLE credit.
•   On-Demand Video: Access CLE 24/7 via on-demand library and watch program anytime. Qualifies for self-study CLE credit. On-demand versions are made available 7 business days after the original recording date and are view-able for up to one year.

Select your state to see if this class is approved for CLE credit.

Choose the format you want.


Original Broadcast Date: August 15, 2018

Hillary Stemple, Esq. regularly advises clients on compliance with health care fraud and abuse laws, with an emphasis on the Stark law and anti-kickback statute. She also advises clients on internal and external investigations, particularly investigations related to the False Claims Act, as well as on reimbursement issues, licensing requirements, and other compliance matters.

As part of her practice, Hillary helps health care clients respond to government subpoenas, address related compliance issues, and negotiate associated settlement
agreements and corporate integrity agreements. She also assists clients with drafting, implementing, and evaluating compliance programs. Hillary has counseled clients on all
aspects of making voluntary self-disclosures, including the drafting and submission of self-disclosures to the OIG Self-Disclosure Protocol and the CMS Self-Referral Disclosure Protocol.

*Not admitted in the District of Columbia. Admitted in Maryland and Pennsylvania only. Practicing under supervision of firm principals.

Hillary is a member of the American Health Lawyers Association.

Accreditation Policy
myLawCLE seeks accreditation for all programs in all states. (Accreditation for paralegals sought thru NALA and NFPA paralegal associations.) Each attending attorney/paralegal will receive a certificate of completion following the close of the CLE program as proof of attendance. In required states, myLawCLE records attorney/paralegals attendance, in all other states attorney/paralegal is provided with the approved CLE certificate to submit to their state bar or governing association.

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Applied MCLE Approvals
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Accreditation on Formats: Live Video Broadcasts, “Live” Re-Broadcasts and On-Demand CLEs

Live Video Broadcasts
Live video broadcasts are new live CLE programs being streamed and recorded for the first time. All of these programs qualify for “Live” CLE credit in all states except NV, OH, MS, IN, UT, PA, GA, and LA —these states require in-person attendance to qualify for “Live” CLE credit.

“Live” Re-Broadcasts
“Live” Re-broadcasts are replays of previous recorded CLE programs, set on a specific date and time and where the original presenting speakers calls in live at the end of the event to answer questions. This “live” element allows for “live” Re-broadcast CLEs to qualify for “Live” CLE credits in most states. [The following states DO NOT allow for “live” CLE credits on re-broadcast CLEs: NV, OH, MS, IN, UT, PA, GA, and LA]

On-Demand CLEs
On-demand CLE classes are available 24/7 via the myLawCLE portal. Attendance to these classes is monitored and recorded via our login process and a certificate of completion is issued upon the close of viewing the program. These CLEs can be viewed at anytime and only qualify for self-study CLE credits.

Many states allow for credit to be granted on a 1:1 reciprocal basis for courses approved in another mandatory CLE jurisdiction state. This is known as a reciprocity provision and includes the following states: AK, AR, HI, CT, FL, ME, MO, MT, ND, NH, NM, VT, NJ, NY, and WV. myLawCLE does not seek direct accreditation of live webinars or teleconferences in these states.

myLawCLE Credit Guarantee
Additionally, on all online CLE programs application for approval will be made in all states where attending attorneys are primarily licensed in. If a registered attorney does not receive credit from their state for any reason, a full refund will be granted.

Section I. Why do providers/suppliers need to self-disclose?
a) Overview of the Stark Law and Anti-Kickback Statute
b) The 60 Day Overpayment Rule
        i. Creation of the Rule – the Affordable Care Act
        ii. 60 Day Rule Requirements
        iii. Limitations of the 60 Day Rule
c) The False Claims Act
d) Enforcement Examples
e) Exclusion

Section II. Options for Reporting and Returning Overpayments

Section III. Pros and Cons of Self-Disclosure

Section IV. The Self-Disclosure Process and Options
a) OIG (improper billing, billing for excluded individuals, AKS, AKS/Stark)
b) CMS (Stark only)
c) Other

Section V. How to Structure Compliance Programs to Mitigate the Need for a Complex Self-Disclosure