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Covid-19 and the Public Health Emergency

On October 13, 2022, the Secretary of Health and Human Services (HHS) officially extended the COVID-19 public health emergency (PHE) for another three months, now valid through January 11, 2023. Additionally, HHS has committed to providing at least a 60-day notice prior to ending the PHE. As of November 17th, there has been no announcement related to ending the PHE so we can anticipate an additional extension in January. However, the situation remains in flux as the senate voted, on the 16th, to end the PHE. This measure would require passage in the house and is one U.S. President Joe Biden has signaled he would veto if it made it to his desk.

The PHE waivers, which were initially created in January 2020, provide flexibility in telehealth treatment, operations, and billing codes. The additional extension provided by HHS should be used by healthcare providers to review policies and procedures and to establish a process to adapt their current practices to the end of PHE. We recommend adding the COVID response, testing, care, and billing to your organization’s compliance auditing and risk assessment plan. Providers should be aware that the PHE waiver is limited to federal programs. Each state that enacted local PHE waivers may make independent decisions regarding the timelines of those waivers.

The Department of Health and Human Services through the Office of the Inspector General has been actively enforcing fraud, waste, and abuse regulations against COVID-19 related schemes that include, but are not limited to, offering counterfeit treatments, illegitimate contact tracing programs, and fraudulent practices with vaccination cards. Providers should be aware that, even though waivers are in place, HHS is actively enforcing and prosecuting actions for fraud, waste, and abuse in all its modalities. Another enforcement trend involves healthcare entities attempting to defraud the COVID-19 related assistance programs. For example, a Missouri state representative, who had an ownership interest in certain medical clinics, was recently convicted by a federal trial jury for nearly $900,000. The conviction states that the accused committed COVID-19 related fraud by utilizing false information on uncovered costs to support grant relief requests under the Payment Protection Program (PPP). These types of Investigations by the OIG will abound, not only pertaining to the PPP but also to the misuse of the Provider Relief Fund, a program implemented by HHS to support healthcare providers during the pandemic.

© Copyright 2022. The views expressed herein are those of the author(s) and not necessarily the views of Ankura Consulting Group, LLC., its management, its subsidiaries, its affiliates, or its other professionals. Ankura is not a law firm and cannot provide legal advice.


healthcare & life sciences, healthcare compliance, healthcare operations, perspective

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