Friday, September 30, 2022
Joan H. Krause (University of North Carolina at Chapel Hill), Revisiting Health Care Fraud in the Biden Administration, 15 St. Louis J. Health Law & Pol'y 361 (2022):
Although not one of the Biden administration’s initial priorities, health care fraud inevitably will be a major concern. First, the federal government’s response to the COVID-19 pandemic—including the disbursement of more than $175 billion in provider relief funds and the loosening of traditionally strict rules on Medicare reimbursement for telehealth services—has created new opportunities to divert health care funds for fraudulent purposes. Second, President Joseph Biden took office in the midst of the incomplete transition from volume-based to value-based payment in the federal health care programs, which will allow fraud to flourish in the gaps between multiple reimbursement systems. Third, regardless of these developments, prior forms of fraud are likely to continue. Thus, the Biden administration will have no choice but to devote significant resources to fraud enforcement.