CMS May Soon Allow Expedited Processing for SRDP Filings Disclosing Potential Technical Stark Law ViolationsPDF
Health care providers that wish to voluntarily disclose potential technical violations of the federal Stark Law may soon be able to take advantage of a new expedited process. This process may save disclosing providers a great deal of time and expense.
In 2010, the Patient Protection and Affordable Care Act required the establishment of a Self-Referral Disclosure Protocol for potential Stark violations and authorized the reduction of payment amounts to settle those potential violations disclosed through the SRDP. Since the SRDP’s inception, there has been only one process through which providers may make voluntary disclosures. Disclosing providers have typically faced long waits between their initial SRDP submission and its ultimate review and settlement. With only 44 published settlements issued to date, over 350 disclosures are awaiting review.
However, change may be on the horizon. Disclosing providers may soon be able to choose a separate expedited process for potential technical violations of the Stark Law. In May of this year, the Centers for Medicare and Medicaid Services requested public comments on a proposal to alter the SRDP for potential violations meeting certain criteria.1 According to a Supporting Statement issued in conjunction with CMS’ call for comments, the new expedited process would be available for disclosures concerning potential violations that carry no indications of fraud and involve common arrangements, such as leases or personal services.
Rather than requiring extensive factual explanations, as the current SRDP process requires, the expedited process would be more streamlined. Providers taking advantage of the expedited process might only need to submit “certified factual statements and brief narrative summaries” of the potential violations.
This new option would be ideal for providers whose potential violations revolve around technical mistakes or omissions or whose potential violations do not involve complex legal or factual situations. The new process may provide a more cost-effective alternative, for example, in cases involving missing signatures on personal services arrangements, recruitment agreements or leases.
Providers would not be required to use the new expedited process and would have to specifically elect to be subject to the expedited process when making their disclosure. As of now, there is no indication that expedited processing could be applied to disclosures that have already been submitted to CMS that are awaiting review.
Such changes to the SRDP process would be welcome news, both for providers and for CMS. The new process would decrease burdens for healthcare providers making self-disclosures and would significantly reduce processing times for CMS, which expects to continue to receive approximately 100 disclosures per year, double its initial projection. CMS estimates that approximately half of all anticipated self-disclosures would qualify for the new expedited SRDP review process.
Special thanks to Bernard Funk, Yale Law School class of 2016, for research assistance.
1. Agency Information Collection Activities: Submission for OMB Review; Comment Request, 79 Fed. Reg. 25,133 (May 2, 2014).