The Centers for Medicare & Medicaid Services (CMS) recently published updated data regarding settlements made under the Voluntary Self-Referral Disclosure Protocol (SRDP), an important mechanism through which providers may disclose actual or potential violations of the federal physician self-referral prohibition commonly known as the Stark Law. Although the data remain limited, they show another significant increase in the number of disclosures settled in the past year—in all, CMS settled 176 disclosures during 2023, more than any year before by a wide margin. While the number of settlements is up for the second consecutive year, the amounts paid thereunder appear to be generally consistent with years past, though observers should resist the temptation to read too much into the data.


The Affordable Care Act required the establishment of a voluntary self-referral disclosure protocol that sets forth a process through which providers may disclose actual or potential violations of the Stark Law. In accordance with this mandate, CMS established the SRDP on September 23, 2010.

Over the years, CMS has published certain information about SRDP settlements. Initially, CMS published short descriptions of each settlement, including a general description of the disclosing party (e.g., an acute care hospital located in Tennessee), the nature of the actual or potential violation (e.g., failure to satisfy the requirements of the personal services arrangements exception for certain physicians), the date of the settlement, and the amount paid thereunder.

In 2016, CMS changed course. Rather than reporting each individual settlement, it began reporting the data on an aggregate level. Specifically, CMS reported, for each year, the number of disclosures settled, the range of amounts of settlements, and the aggregate amount of settlements. CMS has continued to report SRDP settlements in this format ever since, generally updating the data yearly.

New SRDP Settlement Data

On March 21, CMS provided its latest update. The following graph depicts, by year, the total number of settlements and the aggregate amount paid.

SRDP Settlements

While the agency resolved 103 submissions in 2022—a significant increase over the 27 resolved in 2021—CMS again increased the pace in 2023, resolving 176 settlements over the year. The 176 settlements mark the largest number of settlements in a year thus far. This accelerated pace is consistent with public statements from CMS representatives that the agency has recently devoted more resources to resolving SRDP matters. CMS representatives have shared that CMS is reviewing and responding to many submissions as they come in rather than responding in the order in which they were received, which we have seen firsthand.

Although the data show an uptick in the number of settlements, the amounts paid appear to be fairly consistent from year to year. In 2022, the 103 settlements ranged from $299 to $1,171,174 and yielded a total of $9,287,866. In 2023, the 176 settlements ranged from $26 to $548,302 and yielded a total of $12,560,017. As shown below, these numbers, and the average settlement values they suggest, appear to align with historical values.

Average SRDP Settlements

Having said that, it is important to remember that there is no “average” SRDP submission, nor is there a discernible formula that can be used to predict the settlement amount. CMS evaluates the facts and circumstances of each submission individually and may consider various factors, including, among other things, the nature and extent of the improper or illegal practice, the timeliness of disclosure, and the cooperation of the disclosing party.

It is also worth noting that, as of December 31, 2023, CMS reports that 267 SRDP submissions have been withdrawn, closed without settlement, or settled by CMS’s law enforcement partners. This number reflects an additional 35 submissions so resolved since December 31, 2022, and an additional 112 since December 31, 2020. This increase may relate to CMS’s efforts over the past few years to ensure that disclosing parties have fully considered recent clarifications regarding requirements common to many Stark Law exceptions, such as those relating to documentation and signatures.


In 2022 and 2023, over 275 SRDP submissions were either settled through the SRDP or withdrawn, closed without settlement, or settled by CMS’s law enforcement partners. These figures reflect a substantial undertaking, one that is consistent with public statements from agency representatives that CMS has devoted more resources to resolving disclosures. Those who await a settlement offer should know that the conventional wisdom on timing has changed. Resolution may come sooner than you expect.

If you have any questions about the latest SRDP settlement data or the SRDP process generally, please contact the authors.