Home Health & Hospice Week

If you thought you were in the clear because you’ve paid back CAAP payments, you might want to think again.

As required by the CARES Act, CMS began recouping CAAP payments after 12 months, with the earliest repayments coming due in March 2021. Beginning at that year mark, the repayment schedule was 25 percent of the CAAP total for 11 months, 50 percent for six months, and then 100 percent of the balance due at “29 months from the initial issuance of the CAAP,” CMS notes in a CAAP Frequently Asked Question set last updated in August.

That 29-month mark hit in September 2022 for the earliest CAAP recipients, notes CMS in a repayment and CAAP disbursement brief. But the exact date of the balance coming due varies, depending on when providers received their payments. CMS hasn’t updated its statistics since last year, but as of Nov. 30, 2022, the agency still had more than $1.4 billion yet to recoup from providers.

Case details: This is the first conviction DOJ has brought for misappropriating funds from the CAAP program and “marks another example of the government’s enforcement efforts to address COVID-19-related fraud,” say attorneys Sophie Mourous and Timothy Fry with law firm McGuireWoods in the firm’s FCA Insider blog.

“Joseph received approximately $250,000 from these funds and fraudulently used the money to pay for his own personal expenses, and not in accordance with the terms of the relief programs,” explains a DOJ release. Joseph was convicted in a D.C. court for theft of the funds and wire fraud; he was acquitted of a theft charge for a separate COVID-relief payment.

Of the total amount, the court homed in on $87,000 in CAAP funds Joseph illegally transferred to a family member, explain Mourous and Fry.

Important: That’s why thorough recordkeeping and reporting are critical. “While a particularly egregious example, other smaller providers should ensure they have kept records on how they used these funds to further the provider’s ability to provide care at the start of the pandemic, rather than take advantage of government funding in a manner that could be challenged in the future,” Mourous and Fry say.

DOJ has already prosecuted more than 200 individuals in 130 cases for CARES Act fraud from payments received through the PPP, PRF, and Economic Injury Disaster Loan program, the release notes. “The Fraud Section has also seized more than $80 million in cash proceeds derived from CARES Act-related fraud schemes, as well as numerous real estate properties and luxury items purchased with such proceeds,” the DOJ says.

Note: CMS’ CAAP webpage with links to the FAQs is at www. cms.gov/medicare/covid-19-accelerated-and-advance-payments, and CMS data on CAAP recoupment is at www.cms.gov/files/document/ medicare-caap-repayments-publication-11-30-2022.pdf.