Justice Department’s Civil Division and the Department of Health & Human Services Announce Anti-Fraud Healthcare 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), which 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. This civil pilot program builds on longstanding Department principles, discussed further here and here, to promote predictable and efficient resolution of corporate misconduct while recovering damages and penalties for taxpayers.[1]

"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."

"By providing predictable and clear incentives for self-disclosure, this pilot program offers responsible companies an opportunity to move forward as stronger partners to federal healthcare programs," said Deputy Assistant Attorney General Brenna Jenny of the Justice Department's Civil Division. "When companies identify misconduct and take meaningful steps to fix the problem and repay the government plus penalties, the Department will take those actions into account in determining appropriate resolutions."

Participants must describe all relevant details relating to the disclosing company's conduct that potentially violates the federal FCA and produce documents sufficient to fully reflect the nature, terms, and operation of the disclosed potential FCA violations. Self-disclosing companies must describe the remedial actions they have taken and make a financial repayment with a 1.25-1.6 multiplier. The multiplier applied will vary based on factors such as the timeliness of the self-disclosure, the duration and scope of the misconduct, the involvement of senior leadership, the financial benefit to the disclosing company, and whether the disclosing company has successor liability for the misconduct 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 to [email protected]. The FCA SDPP will accept submissions through April 22, 2027. Late and incomplete submissions will not be reviewed.

Note: A copy of the FCA SDPP protocol is available here.