DOJ Civil Division and HHS Launch Healthcare FCA Self-Disclosure Pilot Program
The Department of Justice Civil Division has partnered with the Department of Health and Human Services (HHS) to launch a Healthcare False Claims Act Self-Disclosure Pilot Program (FCA SDPP), the department announced on Oct. 22. The program is designed to give healthcare companies a way to quickly resolve past misconduct by self-disclosing potential violations of the federal False Claims Act (FCA) and to prioritize the government's resources toward recalcitrant actors, the department said.
"Voluntary self-disclosure is a powerful indicator of a company's commitment to compliance and accountability," said Assistant Attorney General Brett A. Shumate of the Justice Department's Civil Division. "This pilot program offers a favorable resolution framework to companies that want to take responsibility for past conduct while allowing the Department to concentrate resources on those who deliberately exploit our healthcare system. But for companies unwilling to take accountability, the Civil Division, in partnership with whistleblowers, will root out the fraud." Deputy Assistant Attorney General Brenna Jenny said that by providing predictable and clear incentives for self-disclosure, the pilot offers responsible companies an opportunity to move forward as stronger partners to federal healthcare programs, and that the department will take remediation and repayment into account in determining appropriate resolutions.
Participants must describe all relevant details of conduct that potentially violates the federal FCA and produce documents sufficient to fully reflect the nature, terms, and operation of the disclosed violations. Self-disclosing companies must describe the remedial actions they have taken and make a financial repayment with a 1.25-1.6 multiplier, which varies based on factors such as the timeliness of the disclosure, the duration and scope of the misconduct, the involvement of senior leadership, the financial benefit to the company, and whether the company has successor liability but promptly remediated. In exchange, companies will receive a coordinated civil release from liability under the federal False Claims Act and certain HHS administrative authorities.
Companies may submit self-disclosures electronically, and the FCA SDPP will accept submissions through April 22, 2027; late and incomplete submissions will not be reviewed. The department noted the pilot covers conduct that potentially violates civil laws; a company seeking to disclose potential criminal healthcare conduct must do so to the Justice Department's National Fraud Enforcement Division under the separate coordination policy with the HHS Office of Inspector General.
Published by GSM · USA (original Chinese edition)
Photo: 图：美国卫生与公众服务部总部 Hubert H. Humphrey 大楼。照片：CC BY-SA 4.0，经 Wikimedia Commons。 / The Hubert H. Humphrey Building, headquarters of the U.S. Department of Health and Human Services. Photo: CC BY-SA 4.0, via Wikimedia Commons.
