CMS relief payments in compliance during COVID-19, OIG finds
CMS appropriately made CAAP Program payments to all 100 providers that were randomly selected in the OIG's audit.
Photo: Emir Memedovski/Getty Images
Advanced Medicare payments to providers in the early days of the COVID-19 pandemic – about $103 billion worth – were compliant with federal and congressional requirements, meaning they largely hit their mark, according to a new report from the Office of the Inspector General.
The OIG conducted an audit covering $103.1 billion in total COVID-19 Accelerated and Advanced Payments (CAAP) Program payments made to 46,373 providers. It selected a stratified random sample of 109 providers and reviewed the CAAP Program payments totaling $4.1 billion made to those providers.
Of those 109 providers, 100 were randomly selected and nine were under bankruptcy when the CAAP Program payments were made.
The Centers for Medicare and Medicaid Services generally made CAAP Program payments to providers in compliance with the Coronavirus Aid, Relief, and Economic Security (CARES) Act and other federal requirements, the watchdog group found. Of the 109 providers in the sample, CMS appropriately made CAAP Program payments to all 100 providers that were randomly selected. For the nine providers under bankruptcy, CMS did not send a CAAP Program payment to six of them, though it did make a CAAP program payment to three.
The CAAP Program payments made to the three providers under bankruptcy occurred because two Medicare Administrative Contractors (MACs) did not correctly match the provider's request against their bankruptcy databases, and one MAC did not update its bankruptcy database based on bankruptcy information that was provided by CMS prior to approving the CAAP Program payment request.
For the three CAAP Program payments made to providers under bankruptcy, the MACs immediately identified their errors after the payment and recovered the improper payments.
WHAT'S THE IMPACT?
The OIG framed the audit as part of its oversight of the Department of Health and Human Services' COVID-19 response and recovery efforts, saying the pandemic has created extraordinary challenges for the delivery of healthcare.
The audit was part of the OIG's COVID-19 response strategic plan. Although the MACs erroneously approved CAAP Program payments to nine providers under bankruptcy, they immediately identified their errors, stopped payments to six providers, and recovered improper payments made to the other three providers – meaning the OIG is issuing no recommendations at this time.
THE LARGER TREND
CMS can provide temporary relief loans through the accelerated payment program for certain Part A providers, and through the advance payment program for certain Part B providers and suppliers – particularly when these providers and suppliers face cash flow challenges due to circumstances beyond their control.
The CARES Act, which Congress passed March 27, 2020, expanded these programs to more providers to relieve pandemic-caused financial strain. The CMS referred to this expansion as the CAAP Program and issued eligibility criteria March 28, 2020.
As of September 17, 2020, CMS, through the MACs, disbursed more than $100 billion in CAAP Program payments to more than 46,000 providers. These CAAP Program payments were issued in a short period of time, thus increasing the risk of improper payments, the OIG said.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
