OIG Self-Disclosures

The Provider Self-Disclosure Protocol (SDP) establishes “the process for health care providers to voluntarily identify, disclose and resolves instances of potential fraud involving Federal health care programs.” It was first published by HHS-OIG in 1998. In April 2013, it was updated and republished to provide additional guidance to the health care community. The April 2013 SDP supersedes and replaces the prior SDP and all Open Letters that followed.

In keeping with its sentinel approach to program integrity, the SDP encourages self-reporting because it believes that all members of the health care community have a “legal and ethical duty” to deal with federal health care programs with integrity. The OIG provides the following benefits for disclosure:

    • A presumption against requiring a corporate integrity agreement
    • Lower multiplier on damages
    • Mitigation of exposure from the overpayment requirements of the FCA


All health care providers and suppliers who are subject to OIG’s CMP authority can use the SDP. Providers and suppliers that make a disclosure are referred to as “disclosing parties.” Disclosing parties who are already under investigation or audit are not automatically precluded from making an SDP disclosure, but they must do so in good faith. The SDP process is only for disclosing potential violations of criminal, civil or administrative laws for which CMPs are authorized – this includes the FCA and the AKS. The SDP is not to be used for reporting overpayments, which are generally reported to the MAC, or Stark law violations, which are reported to CMS through its Self-Referral Disclosure Protocol. 

The disclosing party must specify the particular law and violation it is disclosing and acknowledge that the conduct being reported is a potential violation. It is equally important that the disclosing party has taken corrective actions to ensure that the conduct has ended. It is important for counsel and the client to identify the root cause of the violation and ensure that corrective action has been taken or is underway.

Improper Claims

The SPD provides a detailed list of the requirements that must be included in the disclosure. Disclosures can be made online or submitted by mail. Where the disclosure involves the submission of improper claims, the disclosing party must conduct a review of the claims and provide a damage estimate. The SPD provides detailed guidance for this review and estimate. Of course, counsel and the client should retain the necessary outside auditors and experts to conduct this review both for the expertise and the objectivity that external auditors can provide.

Cooperation With OIG

Cooperation and a genuine desire to right the wrong is the essential element of the SDP. This includes submitting all information on a timely basis, communicating through a consistent and highly responsive point of contact, and being willing to pay fines and penalties on a timely basis. The OIG states, “Disclosing parties who fail to cooperate with OIG in good faith will be removed from the SDP.”

The essential components of any successful self-reporting, disclosure or settlement of a government investigation are the following:

    • Swiftly conduct an effective internal investigation
    • Identify the root cause of the overpayment or violation
    • Quickly develop and implement an effective corrective action plan
    • Identify and quantify any overpayments
    • Refund any overpayments or fines to the government

Chapman Law Group: Attorneys Representing Healthcare Professionals Nationwide With OIG Matters

The audit attorneys at Chapman Law Group have been helping health care providers for 35 years. We understand that with allegations of healthcare fraud, your livelihood may be at stake. We will fight to protect it, and we will work with you in making sure your healthcare practice is in compliance.

We represent providers and practices nationally — from Chicago to Los Angeles, and from Miami to Detroit — during Medicare audits, Medicaid audits and third-party payor audits. Our team of Medicare and Medicaid audit attorneys has extensive experience in Medicare audits, including ZPICRAC, and Safeguard (PSC) audits.

The Medicare and Medicaid audit attorneys at Chapman Law Group have been helping health care providers for 35 years. We practice across Michigan, including the Detroit, Ann Arbor, Grand Rapids, Dearborn and Troy areas; in Florida (Miami, Tampa, Jacksonville, West Palm Beach, Orlando and other regions), and nationally in regions including Los Angeles and Southern CaliforniaChicago, Pittsburgh, and Washington, D.C.

Our extensive experience in key areas of regulatory compliance in healthcare include:

We represent licensed medical professionals across the U.S., including:

Our offices are in Detroit (where we serve Dearborn, Troy, Ann Arbor and Grand Rapids, and the rest of Michigan); Miami and Sarasota, Florida (for Jacksonville, Tampa, Orlando, West Palm Beach, and all of Florida); Los Angeles/Southern California; and Chicago

With lawyers dedicated to helping providers defend their claims during audits, recovery action and appeals, you are in strong hands. Contact us today for a consultation.

Need an Attorney? Contact us now!


  • This field is for validation purposes and should be left unchanged.


  • This field is for validation purposes and should be left unchanged.

Got A Question?

Contact me now to schedule a consultation.

Other Practice Areas


Related Case Results

Healthcare Audit Defense Attorneys

Here’s what health care providers and practices need to know about Medicare audits, Medicaid audits and third-party payor audits — and how our healthcare defense lawyers can help you.

Read More »

Related Blog Posts

FREE Health Care Newsletter

Stay up to date on the latest news in health care law!

FREE eBook!

Click the link below to download our compliance eBook now!

Got A Question?

Contact me now to schedule a consultation.
Chapman Law Group Favicon

This website uses cookies to ensure you get the best experience on our website.

Send this to a friend