tci Medicare Compliance & Reimbursement - 2021 Issue Q1
Enforcement: Feds Ramp Up COVID-19-Related Enforcement
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Article Overview
This article summarizes how federal healthcare oversight has intensified around COVID-19-related fraud, audits, and compliance concerns while also continuing attention to broader enforcement areas. It is aimed at providers, compliance staff, coders, auditors, and healthcare legal professionals who need to monitor OIG, DOJ, and related federal activity affecting claims, telehealth, funding, and program integrity.
Why This Topic Matters
Healthcare organizations need to understand where federal enforcement is concentrating so they can review compliance risks, internal controls, and audit exposure across pandemic-era programs and ongoing routine oversight.
Article Sections
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Be Aware of These 4 COVID-19 Fraud Problem Areas
Introduces the main pandemic-related enforcement and audit themes discussed in the article. It frames the broader compliance environment and the federal agencies involved.
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CARES Act funding
Covers federal oversight activity related to pandemic funding programs and related investigations. The section also notes concern around misuse of relief-related resources and recipient compliance.
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COVID-19 testing
Discusses fraud trends tied to testing activity during the pandemic. It focuses on current enforcement attention around deceptive testing-related schemes.
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COVID-19 vaccinations
Reviews enforcement concerns tied to vaccination rollout, access, registration, and related compliance issues. The section highlights how federal agencies are viewing vaccine-related fraud risks.
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Telehealth
Summarizes compliance concerns associated with telehealth policy changes during the public health emergency. It also notes ongoing audit attention to telehealth-related claims.
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Example
Provides an example of a non-pandemic enforcement area that remains under federal review. It illustrates how broader audit priorities continue alongside COVID-19 focus areas.
What You Will Learn
- How federal healthcare enforcement priorities have shifted during the COVID-19 public health emergency
- Which broad pandemic-related compliance areas are drawing audit and fraud attention
- How telehealth policy changes are being viewed in the enforcement environment
- What other non-pandemic audit topics remain active alongside COVID-19 issues
Who Should Read This
- Healthcare providers
- Compliance officers
- Medical coders
- Billing and reimbursement staff
- Healthcare auditors
- Healthcare attorneys
- Practice managers
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