United States Enacted The Patient Protection And Affordable Care Act

777 Words Nov 9th, 2015 4 Pages
In 2010, through President Barrack Obama’s advocacy, the United States enacted the Patient Protection and Affordable Care Act (“PPACA”) in an effort to ensure that all Americans have access to health coverage. As part of the PPACA Congress directed the Secretary of the U.S. Department of Health and Human Services (“HHS”) to develop and implement a Medicare Self –Referral Disclosure Protocol. The SRDP is intended to foster the resolution of potential or actual violations of Stark. This Section will give an in depth look at disclosures prior to SRDP, its enactment and the important developments in its brief existence.
1. Disclosures Prior to the SRDP
Prior to this enactment providers had the option to make unsolicited or voluntary refunds to Medicare administrative contractors who process claims and issue payments on behalf of CMS. Generally, these refunds are in the form of adjustment bills or checks. The Medicare contractors process the refunds and review the circumstances surrounding the overpayment and take appropriate steps to resolve the issue. Entities could also request an advisory opinion from CMS to resolve violations. For CMS to consider an advisory opinion the requester must be a party to the existing agreement and is the only individual or entity that may rely on that opinion.
Also, entities could make disclosures through the Office of Inspector General (“OIG”) under its Self-Disclosure Protocol (“SDP”). Today a Stark violation may still be…
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