COVID TESTING FRAUD?
A premium (subscription) article by Adam Bonislawsky at 360DX (part of Genomeweb) reports that HHS is taking aim at COVID testing fraud (here). OIG is investigating and DOJ has already starting leveling charges at some perpetrators.
Publicly available sources cited by 360DX or via Google include:
- OIG announces a trend analysis to better understand the skyrocketing rates of COVID claims - here.
- On July 7, OIG posted a "Fraud Alert" along with an informational 2 minute video - here.
- In June, Washington Post published that a lab called Arrayit was facing allegations - here. See also a DOJ press release here.
CMS SPENDING ON PUBLIC RELATIONS
In 2019, Politico "broke a story" about high spending by CMS on public relations firms. The public relations firms were said to have close connections to top Republican officials.
On July 16, OIG released a 73-report of its investigation. Here. Politico reports on the OIG document here. Articler at "The Hill" here.
OIG summarizes in part, "We audited three contracts, totaling $6.4 million, awarded for strategic communications services from June 2017 through April 2019. ... CMS allowed a subcontractor individual to perform inherently governmental functions, such as making managerial decisions and directing CMS employees. CMS also administered its strategic communications services contracts as personal services contracts. CMS officials exerted a level of control over the contractors' work that exceeded what is allowed under service contracts; in essence, CMS administered these contracts as if the services had been procured under CMS's statutory authority to contract for experts and consultants. Lastly, CMS did not comply with FAR requirements in managing contract deliverables..."
Beginning on page 59, CMS issues a detailed 9-page response, while noting that this type of contracting has many "ambiguities and complexities." For example, OIG alleges overlapping duplicate payments (e.g. page 32) while CMS responds that the OIG did not identify any specific duplicate payments (page 65-66).
CMS states that OIG should not have undertaken the investigation currently, since COVID is a more important national issue ("Verma chastized the OIG..." here.) However, the Hill requested OIG to conduct the investigation on March 29, well into the COVID period (here).
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Separately, on July 15, OIG published another in its series of reports on hospitals overcoding for "malnutrition" and erroneously garnering higher DRG payments - here. This is a topic OIG has investigated before.
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In separate Seema Verma news this week, she published an Op Ed in Health Affairs on the importance and impact of expanded telemedicine in Medicare - here.
