On March 28, 2017, the Centers for Medicare and Medicaid Services (CMS) posted a revised Voluntary Self-Referral (Stark) Disclosure Protocol (SRDP), which replaces the prior version of the protocol. Under the Affordable Care Act (ACA), providers generally must return overpayments within 60 days after identification (the 60 Day Rule), and the SRDP is one of the primary tools that providers can use to return overpayments caused by an actual or potential violation of the Stark Law. The revised protocol now requires information to be submitted on detailed Disclosure, Physician Information, and Financial Analysis Worksheet forms, along with a Certification. A supplemental cover letter is optional.
Linda A. Baumann
Linda Baumann is the leader of the Arent Fox Health Care group in Washington, DC. She concentrates her practice on matters involving False Claims Act Investigations, fraud and abuse compliance, and Medicare/Medicaid reimbursement. In particular, she counsels clients nationwide on matters related to the Stark Law, Anti-Kickback Statute and the False Claims Act.
Linda represents a wide range of companies throughout the industry from Fortune 50 corporations and national chains to community health care providers and trade associations. She helps clients who are dealing with federal and/or state government investigations, handling all aspects from initial audit through successful negotiation and settlement. She has also handled voluntary self-disclosures, implemented and updated corporate compliance programs, served as an independent review organization, advised on Corporate Integrity Agreements (CIAs), conducted due diligence in connection with acquisitions and financing, and helped clients structure transactions to promote business goals while ensuring compliance.
Linda often is able to help clients reduce the scope and amount of their liability, e.g., by demonstrating the legality of their practices, narrowing the scope of exposure and/or negotiating favorable settlements.
Linda’s clients have included hospitals, nursing homes, various types of therapy and diagnostic facilities, clinical laboratories, home health agencies, trade associations, pharmaceutical and medical supply manufacturers and distributors, and many other organizations doing business within the health care industry. She has helped numerous clients conduct internal investigations, respond to government subpoenas and CIAs, return overpayments, and make self-disclosures when necessary. In addition to advising clients on the fraud and abuse issues unique to contracting in the health care industry, Linda has handled a wide range of reimbursement-related issues such as billing and coding, licensure, Medicare enrollment, one day stays/observation status, outliers, hospital-based providers, requisite supervision levels, and services furnished by excluded providers as well as marketing practices and off-label promotion.
Before joining Arent Fox, Linda practiced in the DC area with a nationally recognized law firm. Previously, Linda worked in the General Counsel’s Office of the Department of Health and Human Services, Public Health Division and in the Legal Advisor’s Office of the US Department of State. She also has taught at Princeton University.
Linda is very active in the health law bar. In 2010 she was elected to serve as Chair of the 10,000-member American Bar Association’s (ABA) influential Health Law Section after serving on the Governing Council in various leadership positions since 2003. She also has served as the Chair of the ABA Breast Cancer Task Force and the American Health Lawyers Association Task Force on Medicare Part D. She recently was named to the ABA’s Legal Opportunity Scholarship Fundraising Committee.
Publications, Presentations and Recognitions
Linda is editor-in-chief of Health Care Fraud and Abuse: Practical Perspectives, a widely-used treatise published by the American Bar Association and BNA Books, now in its third edition (2013). Recognized by Chambers USA as a “Leading Lawyer” in health care, she also is rated an AV Preeminent rated lawyer by Martindale-Hubbell. In 2013, Washingtonian magazine gave Linda its “Top Lawyer” rating in health care. She has been recognized for several years as one of the country’s “Outstanding Fraud and Compliance Lawyers” by Nightingale’s Healthcare News and is listed in Who’s Who in America, Who’s Who in American Law, Who’s Who in the World, and Who’s Who of Women. She also has been selected as a Fellow of the American Bar Foundation and has been named to the Advisory Board of BNA’s Health Care Fraud Report, Eli’s Rehab Reporter, and Physician Compliance Alert.
Linda has published numerous articles and is quoted in national publications from Modern Healthcare to the Report on Medicare Compliance and the National Law Journal. She is a frequent speaker before national audiences on fraud and abuse, government investigations, the Anti-Kickback Statute, the Stark Law, the False Claims Act, corporate compliance, PPACA (healthcare reform) and various other health law topics.
Linda’s recent speeches include:
- “Internal Investigation Case Studies: The Good, the Bad and the Ugly,” ABA Sixth Annual National Institute on Internal Corporate Investigations and Forum for In-House Counsel, Washington, DC; April 24, 2014
- “Responding to the Increase in Stark Law Enforcement Actions: Limiting Exposure to Liability,” ACI Conference on Healthcare Provider Disputes, Miami, FL; March 7, 2014
- “Government Auditors are Scrutinizing Medical Staff Activities: How Can You Protect Yourselves?” Medical Staff Leaders and the Law Conference, Newport Beach CA; February 7, 2014
- “False Claims Act Fundamentals and Trends,” ABA webinar; February 6, 2014
- “Government Whistleblower Regimes: Conducting Internal Investigations in the Life Sciences and Health Care Industries to Reduce False Claims Act Exposure,” ABA’s Fifth Annual National Institute on Internal Corporate Investigations/Forum for In-House Counsel; April 24, 2013
- “Stark Law Basics,” ABA Center for Professional Development; January 24, 2013
- “Preparing for Unprecedented Fraud and Abuse Scrutiny in the Long Term Care Setting,” American Conference Institute; January 23, 2013
- “Investigations in the Health Care/Pharma/Device Context: Lessons Learned and their Applicability to Other Industries;” Third Annual National Institute on Internal Corporate Investigations and Forum for In-House Counsel, May 5, 2011
- “Long Term Care Organizations Liability for False Claims Act, Quality of Care and Medically Unreasonable and Unnecessary Services,” American Conference Institute; April 4, 2011
- “Healthcare Reform’s Program Integrity Provisions Change the Game: Key Requirements You Need to Know as Implementation Begins,” Strafford Webinar; February 17, 2011
- “OIG’s Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse,” ABA Health Law Section Teleconference; December 10, 2010
- “Healthcare Reform’s Immediate Impact on Hospitals and Providers: Prepare Now to Comply With the Tough New Program Integrity Provisions;” Strafford Publications Teleconference; May 26, 2010
- “Dollars for Doctors? What You Need to Know Now About the Stark Law,” American Bar Association Annual Meeting, July 31, 2009
- “The Stark Law and Regulations in 2009: Coming into Compliance,” New Jersey Hospital Association Teleconference, March 13, 2009
- “The 2009 Physician Fee Schedule: Anti-Markup, IDTF and Gainsharing Developments,” American Bar Association Teleconference; November 12, 2008
- “Staying out of the Danger Zone: When Drug and Device Companies Contract with Hospitals or Physicians — The Legal Framework,” CBI’s Bio/Pharmaceutical and Medical Device Forum; October 15, 2008
- “How to Compensate Physicians and Stay Out of Trouble: Lessons on Fair Market Value from Deferred Prosecution Agreements,” CBI Teleconference; September 25, 2008
- ABA Teleconference: Stark Perspectives: Self-Referral Provisions in the 2009 IPPS Final Rulemaking; August 28, 2008
Linda’s publications include:
- Health Care Fraud and Abuse: Practical Perspectives, First Edition (2002), Second Edition (2007), and Third Edition (2013)
- “The New 2009 Physician Fee Schedule: Key Changes in Connection With Furnishing, Billing for Diagnostic Tests But No Stark Gainsharing Exception,” BNA’s Health Law Reporter, Vol. 17, No. 47, December 4, 2008
- “New Stark Phase III Regulations,” Health Care Compliance Association; November 2007
- “On-Call Alert,” DCHA; October 2007
- “CMS Proposes Several Reforms for Stark Law in 2008,” Ocular Surgery News Compliance and the Law; September 1, 2007
- “Evaluating Program Effectiveness: Checklists for Compliance,” Compliance Report for Hospitals, Laboratories and Physician Practices; April 2005
- “The Compliance Evolution: Supplemental OIG Guidance Addresses Evolving Risk Areas,” Compliance Report for Hospitals, Laboratories and Physician Practices; March 2005
Life Beyond the Law
Linda enjoys spending time with her three sons whenever she can catch up with them. She is a volunteer with the National Park Service on the Mall, and often serves as a docent at the Jefferson Memorial. Linda also serves on the Governing Board of Arena Stage, a preeminent theater in Washington, DC that is a national center for the production, presentation, development, and study of American theater.
Blog Posts by Linda A. Baumann
In the Compliance Today article, “OIG’s revised exclusion criteria: Reducing the risk,” Arent Fox Health Care partner and leader of the DC practice Linda Baumann and Health Care associates Samuel Cohen and Hillary Stemple discuss the updated criteria that the US Department of Health and Human Services Office of Inspector General (OIG) will consider when deciding whether to exercise its permissive exclusion authority. The law gives the OIG discretion to exclude individuals or entities from participation in federal health care programs on numerous grounds, and such exclusion is often referred to as a financial “death sentence.” In addition to describing the new features in the OIG guidance, including the risk factors that the OIG is likely to consider in making the exclusion determination, the article provides guidance on steps that may help reduce the risk of exclusion.
ABOUT ARENT FOX LLP
Arent Fox LLP, founded in 1942, is internationally recognized in core practice areas where business and government intersect. With more than 350 lawyers, the firm provides strategic legal counsel and multidisciplinary solutions to clients that range from Fortune 500 corporations to trade associations. The firm has offices in Los Angeles, New York, San Francisco, and Washington, DC.