ROWAN UNIVERSITY POLICY
Title: Responding to Suspected Violations of the Stark Law That Do Not Implicate the Anti- Kickback Statute
Subject: Office of Compliance & Corporate Integrity
Policy No: OCCI 2013:C09
Applies: RowanSOM
Issuing Authority: Rowan President & RowanSOM Dean
Responsible Authority: RowanSOM Chief Compliance & Privacy Officer & General Counsel
Originally Issued: Jan 24, 2013
Revisions: July 1, 2013
Reviewed: Jan 6,2014
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As recommended by CMS, once it is determined by RowanSOM that an alleged violation of the Stark Law has occurred and it wishes to report this alleged violation under the SRDP, RowanSOM shall obtain and report the following information to CMS:
A. A statement describing why RowanSOM believes a violation of the Stark Law may have occurred, including a complete legal analysis of the application of the Stark Law to the conduct related to the alleged violation, as well as any self-referral exception that may apply to the conduct;
B. Describe the circumstances under which the disclosed matter was discovered, as well as, any immediate corrective action which has been taken to prevent the continuation of this alleged violation and/or any potential future violations;
C. Identifying information, including the name, address, national provider identification numbers, CMS Certification Number and Tax Identification Number of the disclosing RowanSOM entity;
D. A statement identifying whether the disclosing RowanSOM entity has a history of similar conduct or has any prior enforcement actions against it;
E. An indication of whether the disclosing RowanSOM entity has knowledge that the matter is under current inquiry by a government agency or contractor;
F. A description of the nature of the matter being disclosed, including the type of financial relationship(s), the parties involved, the specific time periods of potential noncompliance, the circumstances under which the disclosed matter was discovered, the type of designated health service claims at issue, the type of transaction or other conduct at issue and the names of individuals and entities believed to be implicated, along with an explanation of their roles;
G. A financial analysis, that states the amount that is actually or potentially due; describe the methodology for calculating the amount due; and summarize the auditing activity and documents upon which RowanSOM relied in calculating the total amount potentially due, itemized by year, including the "look back" period, (i.e. the time during which RowanSOM entity did not appear to be in Stark compliance.);
H. The steps RowanSOM has taken to refund any applicable claims as directed by the CIA;
I. A statement from RowanSOM certifying that the information provided is true and based on a good faith effort to resolve liability under the Stark law; and
J. The steps RowanSOM will be taking to make disclosures under the SRDP, both electronically and by mail.
By Direction of the President:
Signature on file
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