tci Medicare Compliance & Reimbursement - 2023 Issue Q1

Fraud And Abuse: Physician Convicted of COVID Accelerated and Advance Payment Fraud

Understand CMS’ rules on CAAP usage, reporting, and recoupment. As the COVID-19 public health emergency (PHE) winds down, pandemic-related fraud enforcement is ramping up — and you shouldn’t expect that scrutiny to end any time soon. Context: On Feb. 9, Department of Health and Human Services (HHS) Secretary Xavier Becerra renewed the COVID PHE for a 13th and final time, effective Feb. 11 (see Medicare Compliance & Reimbursement, Vol. 49, No. 4). The declaration followed a previous White House announcement, marking May 11 as the PHE end date. Aligning with HHS updates, the Centers for Medicare & Medicaid...

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