Crowell & Moring Helps St. Francis Hospital Achieve OIG "Self-Disclosure" Settlement
Client Alert | 2 min read | 02.13.04
Crowell & Moring's John T. Brennan, Jr. represented St. Francis Hospital of Greenville, South Carolina in its nationally-reported settlement utilizing the HHS OIG Provider Self-Disclosure Protocol, announced by HHS on February 11, 2004. Utilizing that Protocol, the Hospital and its new owner Bon Secours Health System, were able to influence the process of negotiation and settlement and resolve the matter for much less than could have been imposed under the False Claims Act or Civil Monetary Penalty Law.
Upon its acquisition of the Hospital in 1999, Bon Secours Health System discovered potential improper claims submitted by the previous owner involving the Hospital's home health, hospice and DME services. Bon Secours elected to notify the OIG of these possible false claims through the Provider Self-Disclosure Protocol.
Bon Secours utilized the process to demonstrate to the Inspector General that it had fully audited and identified the scope of the potentially improper filings. While Bon Secours remained obligated for liabilities of the predecessor owner, Crowell & Moring and Bon Secours were able to convince the Inspector General that the deficiencies giving rise to the billing improprieties had been corrected, and that under Bon Secours' ownership, a strong new compliance program was now in place. Crowell & Moring worked with Bon Secours in performing the internal audit and in developing its compliance and corrective action plans.
As a result, St. Francis' payment in settlement ($9.5 million) was far less than what the Hospital's liability could have been under the False Claims Act or Civil Monetary Penalty Law. Importantly - and most unusually - the Hospital was not obligated to establish a Corporate Integrity Agreement, nor was any other administrative sanction deemed necessary.
The OIG's announcement of the settlement reports OIG Acting Principal Deputy Inspector Dana Corrigan's statement that the settlement is a good example of how the Self-Disclosure Protocol benefits both the integrity of Government health care programs and providers who discover and report evidence of potential fraud and overbilling in their organization. Corrigan said, "Taxpayers can be satisfied with this settlement because St. Francis will pay monetary damages to resolve compliance problems that might not have been revealed without the hospital's self-disclosure. And for its part, St. Francis is now able to continue its work and concentrate on future compliance without concern about lingering liabilities related to this conduct."
The OIG Provider Self-Disclosure Protocol worked well for Bon Secours and St. Francis Hospital in this case. However, the Protocol is not always the preferred approach to resolving potential overpayment and/or false billing issues. An alternative approach to consider, for example, might be to communicate directly with the provider's fiscal intermediary or carrier. Federal law mandates that federal health care program overpayments be disclosed to the government. It is important that each particular situation be carefully evaluated as to its potential legal risks, reporting obligations and strategic options.
Insights
Client Alert | 5 min read | 12.12.25
Eleventh Circuit Hears Argument on False Claims Act Qui Tam Constitutionality
On the morning of December 12, 2025, the Eleventh Circuit heard argument in United States ex rel. Zafirov v. Florida Medical Associates, LLC, et al., No. 24-13581 (11th Cir. 2025). This case concerns the constitutionality of the False Claims Act (FCA) qui tam provisions and a groundbreaking September 2024 opinion in which the United States District Court for the Middle District of Florida held that the FCA’s qui tam provisions were unconstitutional under Article II. See United States ex rel. Zafirov v. Fla. Med. Assocs., LLC, 751 F. Supp. 3d 1293 (M.D. Fla. 2024). That decision, penned by District Judge Kathryn Kimball Mizelle, was the first success story for a legal theory that has been gaining steam ever since Justices Thomas, Barrett, and Kavanaugh indicated they would be willing to consider arguments about the constitutionality of the qui tam provisions in U.S. ex rel. Polansky v. Exec. Health Res., 599 U.S. 419 (2023). In her opinion, Judge Mizelle held (1) qui tam relators are officers of the U.S. who must be appointed under the Appointments Clause; and (2) historical practice treating qui tam and similar relators as less than “officers” for constitutional purposes was not enough to save the qui tam provisions from the fundamental Article II infirmity the court identified. That ruling was appealed and, after full briefing, including by the government and a bevy of amici, the litigants stepped up to the plate this morning for oral argument.
Client Alert | 8 min read | 12.11.25
Director Squires Revamps the Workings of the U.S. Patent Office
Client Alert | 8 min read | 12.10.25
Creativity You Can Use: CJEU Clarifies Copyright for Applied Art
Client Alert | 4 min read | 12.10.25
Federal Court Strikes Down Interior Order Suspending Wind Energy Development
