Under the Voluntary Self-Referral Disclosure Protocol (SRDP), health care providers may disclose violations of the Stark Law, which governs physician self-referral for Medicare and Medicaid patients. On May 6, 2016, the Centers for Medicare and Medicaid Services (CMS) issued proposed revisions to the SRDP. These revisions are intended to make the disclosure process more efficient. In addition, these revisions impose new requirements. Physicians may now be required to provide a financial analysis based on a six-year look back period.
The SRDP was established through the Affordable Care Act on September 23, 2010. Although it has proven effective for resolving Stark Law compliance issues, critics have noted that it is often a slow and cumbersome process. There is a significant backlog of disclosures, such that some providers must wait several years for disclosures to work their way through the system.
Previously, the SRDP required that overpayments be reported within 60 days of identification or the date a corresponding cost report is due, and used a four year look back period. Now, under the revised rule, disclosing parties must provide a financial analysis of the potential overpayment based on a six-year lookback period.
CMS also took action to reduce the burden on disclosing parties by streamlining the information required in submissions. In structuring disclosures, the revised SRDP relies on the use of four forms:
- The SRDP Disclosure Form
- The Physician Information Form
- The Financial Analysis Worksheet
- The Certification
In addition, disclosing parties may want to submit a cover letter that includes information that may be relevant to CMS’s evaluation of the disclosure, but this is discretionary.
Although the goal of streamlining the SRDP process sounds promising, no one is certain whether the proposed changes will have the intended effect. Under the previous system, providers were required to craft a narrative, whereas now the process is driven by filling out standard forms. Providers will face new burdens in filling out the complex Financial Analysis Worksheets. CMS has requested public comments on its revisions by July 5, 2016.
Philadelphia Health Care Lawyers at Sidney L. Gold & Associates Provide Effective Counsel on Stark Law Compliance
If you have questions on the Anti-Kickback Statute, the Stark Law, the Anti-Markup Rule, or related issues, the experienced Philadelphia health care lawyers at Sidney L. Gold & Associates can help. With offices located in Center City Philadelphia, we serve clients throughout Pennsylvania, New York, and New Jersey. To schedule a consultation, call us at 215-569-1999 or complete our online contact form today.