Health-care companies reporting potentially criminal fraud now have a single federal disclosure route intended to unlock benefits from both the Justice Department and the health inspector general.
Under a policy announced on October 15, a voluntary disclosure to the National Fraud Enforcement Division’s Health Care Fraud Section can also secure the benefits of the Department of Health and Human Services inspector general’s self-disclosure protocol, without a second submission through its portal.
The reverse does not generally work. A company reporting only to HHS-OIG will generally not have made a voluntary disclosure to DOJ and will generally not qualify for a criminal declination on that basis.
The distinction matters where the same conduct—such as kickbacks or medically unnecessary billing—can produce criminal, civil and administrative exposure.
The announcement does not grant blanket immunity. DOJ said cooperation and remediation remain part of the company’s route to favourable treatment. The separate HHS-OIG process continues to address conduct that may breach civil or administrative law.
