More than $103 billion of accelerated and advanced Medicare payments made to healthcare providers early in the COVID-19 pandemic were “generally in compliance” with the requirements laid out by Congress and the federal government, a government watchdog reports.
The Office of Inspector General (OIG) reviewed payments made by the Centers for Medicare & Medicaid Services (CMS) and its Medicare Administrative Contractors (MACs) to over 46,000 providers before Sept. 17, 2022.
The relief had been authorized under the CARES Act in March, creating a brief period of rapid disbursements and “increasing the risk of improper payments,” the oversight agency wrote in its report.
The office’s audit pulled a random stratified sample of 109 providers that had received a total of $4.1 billion through the COVID-19 Accelerated and Advance Payments (CAAP) Program.
Among these, 100 providers qualified for and received payments that did not exceed the maximum allowable amount as instructed by CMS, according to OIG’s report.
The remaining nine providers did not qualify for a CAAP Program payment because they were under bankruptcy, yet were still included in CMS’ database due to MACs incorrectly entering invoices for processing, the audit found.
After identifying their errors after being informed of the providers’ bankruptcy status, one MAC was able to halt payments to six of the providers before they were deposited, OIG wrote.
Erroneous payments made to the remaining three providers ranged from roughly $400 to $460,000 and were all recovered by the MACs, according to the report.
"Although the MACs erroneously approved CAAP Program payments to nine providers under bankruptcy, the MACs immediately identified their errors, stopped payments to six providers, and recovered improper payments made to the other three providers,” OIG wrote in the report. “Therefore, we do not have any recommendations.”
CAAP Program disbursements land Provider Relief Fund payments to ensure healthcare providers maintained cash flow during shutdowns and elective postponements.
The latter has come under scrutiny from OIG and researchers alike who have criticized early relief waves’ controls and bias toward more advantaged hospitals. Last month also saw a call from the Urban Institute for greater transparency into how the administration has repurposed Provider Relief Fund funds that were voluntarily returned by hospitals.