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The Move to Self-Reporting Continues: Self-Referral Disclosure Protocol

health law complianceBy: James Saling

The Center for Medicare and Medicaid Services (CMS) issued proposed Self-Referral Disclosure Protocol (SRDP) forms and revisions to the regulations on May 6, 2016. This was an additional step in the move for providers to self-report violations of the Stark Law.  Part of the revisions to the regulations came as a result of the final overpayment rule issued earlier this year on February 11, 2016 (60 Day Rule). CMS expects that the SRDP forms will facilitate faster review of a self-disclosure and make it easier for providers to report violations.

The SRDP was established as a result of the Affordable Care Act and is a tool for resolving Stark Law compliance issues. One of the problems with the SRDP is the time that self-disclosures worked their way through the system.  Some self-disclosures have yet to be resolved and were initially made years ago.

It can be beneficial for providers to report violations of the Stark Law using the SRDP. When a provider self-reports an actual or potential Stark Law violation using the SRDP, CMS considers a reduction in penalties associated with such violation.

The proposed SRDP forms are an attempt to streamline the process. The proposed forms include: (1) the SRDP Disclosure Form; (2) the Physician Information Form; (3) the Financial Analysis Worksheet; and (4) the Certification.   The forms require specific and detailed information as to the Stark Law violation, including a very detailed financial analysis that includes a 6-year lookback that mirrors the 60 Day Rule lookback.

Providers should also try to avoid having to use the SRDP by taking proactive measures to decrease their risk of a Stark Law violation, including:

  • Document compensation relationships in a contract
  • Keep up to date records relating to financial and compensation relationships
  • Develop and maintain a Stark Law policy
  • Educate staff as to proper referrals and importance of compliance with the Stark Law

If a provider is aware of a potential or actual violation of the Stark Law, the provider should consult an attorney to confirm whether an actual or potential violation of the Stark Law has occurred and whether a disclosure using the SRDP forms is the appropriate action.