In brief: RID’s impact, CMS’s revocation, Medically Modern’s buy, GenHealth’s Series A

ARLINGTON, Va. – The remote-item delivery (RID) framework for the next round of the competitive bidding program (CBP) could lead to heavy layoffs across the home medical equipment (HME) industry, according to a new survey from AAHomecare.

To capture the real-world impact of the Round 2021 (RID) Competitive Bidding Program, AAHomecare surveyed the industry this August. The results, the association says, confirm what many providers have long feared: This program threatens patient access on a national scale. Based on Medicare claims data, AAHomecare estimates approximately 3,650 suppliers would be impacted by the RID CBP.

A total of 306 companies, representing more than 1,500 locations, participated in the survey, AAHomecare says, providing a broad view of projected business responses.

Key findings include:

• Workforce reductions – 50% would lay off employees; more than one in three said they would eliminate at least half of their current workforce.
• Business viability risk – 47% anticipate significant risk to business viability, closing one or more locations, facing a high risk of going out of business, and/or closing entirely. Extrapolated across the 3,650 impacted suppliers, more than 1,700 DMEPOS companies would face significant viability risk.
• Product category exits – 53% would exit one or more affected product categories, reducing supplier availability nationwide.
• Reduced service areas – 45% would reduce operations or shrink their service area, limiting geographic access to products and services, particularly in rural and underserved communities.
• Impact beyond Medicare – 71% report that the loss of Medicare revenue would also affect their ability to sustainably serve patients covered by other payers, showing the impact would extend well beyond Medicare fee-for-service.

AAHomecare says these findings contrast with CMS's Regulatory Impact Analysis, which stated there would be "no economic impact" from the RID CBP.

The association has shared the data with the White House and vice president's office following a request for more information.

“We appreciate the administration's continued engagement on this issue and welcome the opportunity to discuss these findings further,” said AAHomecare. “We also want to thank the DMEPOS suppliers who participated in this survey. Your willingness to share data on your operations made this a credible, industry-wide picture of the RID CBP's impact and gives AAHomecare the evidence we need to advocate on your behalf.”

Related coverage from HME News:

• Next round of bidding takes shape: CMS proposed new rules, remote delivery CBPs and annual reaccreditation.
• An industry 'dehumanized': Providers say CMS ignored feedback, favors large companies.
• Will providers say no thanks to next round of CBP?

CMS adds 11 medical supply companies to Preclusion List

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has identified and is barring 11 medical supply companies with more than $3.4 billion in suspected fraudulent billing practices in 2025 and 2026 from receiving future Medicare Advantage (MA) Part C and Part D payments.

According to the agency, these 11 durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers:

1. Had submitted no claims prior to 2025
2. Used improper billing practices for their claims
3. Had billed for medical equipment to beneficiaries already deceased
4. Supplied equipment to beneficiaries who never requested or received it

CMS says four of the suppliers had already been revoked from original Medicare and began billing Medicare Advantage plans instead.

“Fraudsters who take advantage of the recently deceased to line their pockets represent a level of indecency that we will not stand for,” said CMS Administrator Dr. Mehmet Oz. “Brazen scams like these have plagued Medicare for decades, but under President Trump’s leadership and working with the White House Anti-Fraud Task Force,  CMS is protecting the Medicare Trust Funds and its beneficiaries by using advanced data analytics to identify fraud networks and stop suspicious payments before the check clears.”

CMS has placed the 11 suppliers on its Preclusion List.

All 11 DMEPOS suppliers billed Medicare for multiple beneficiaries who were deceased. In two cases, suppliers submitted nearly $24 million in claims, payments that CMS stopped by using its original Medicare payment-suspension authority:

• One Florida-based provider submitted approximately $18.4 million in catheter claims over two consecutive days – $6.1 million for 500 beneficiaries on Dec. 15, 2025, followed by $12.3 million for 777 beneficiaries the next day. CMS says it payment-suspension authority prevented those payments from reaching the supplier.
• A Texas-based company submitted approximately $5.5 million in orthotics claims, with investigators interviewing six beneficiaries who said they did not know the ordering providers, had never heard of the company and did not need the orthotics. CMS also identified claims for nine beneficiaries with dates of service after their deaths and determined the supplier was not operational at its reported location.

Additional examples of suspected fraudulent behavior uncovered by CMS include:

• A New Jersey-based firm was placed on the Preclusion List after billing a Medicare Advantage plan for 38 separate encounters in which the beneficiary was already deceased on the reported date of service. The investigation into the supplier also included member complaints where they did not know the providers involved and had never requested or needed the DME equipment provided.
• A Florida-based company suspected of participating in a DME telemarketing scheme involving the oversupply of medical equipment. Several beneficiaries reported they did not receive braces for which the company billed and were not familiar with the supplier.

CMS says it will continue working with HHS-OIG and other program integrity partners to identify suspicious billing, protect beneficiaries, safeguard the Medicare Trust Fund and ensure Medicare dollars support legitimate health care, not fraud.

Related reading:

• OIG to CMS: Stronger fraud efforts are needed for DMEPOS.
• CMS suspends more than 100 DME suppliers in fraud crackdown.

Philips provides update on recalled ventilators

AMSTERDAM – Philips Respironics says it has remediated 101,000 out of 102,000 ventilators as of Sept. 1, 2026. The company says it has remediated 99% of actionable sleep therapy devices.

The company stated in an update posted to its website on Aug. 13:

“Completing the Philips Respironics medical device recall remains our highest priority. With the remediation of the sleep therapy devices almost complete and remediation of the ventilators ongoing, it is important that patients, durable medical equipment providers (DMEs) and clinicians are informed on the latest updates. We will continue to prioritize remediation of registered sleep and respiratory care devices and will also continue to accept returned affected devices at no cost.”

Philips closed its U.S. Patient Portal for registering affected devices as of Jan. 1, 2026.

The company initiated a significant recall of certain vents and sleep therapy devices in June 2021.

Philips agreed to the terms of a multi-year consent decree with the U.S. Food and Drug Administration (FDA) in 2024. The company also agreed to pay $1.1 billion to resolve personal injury litigation and medical monitoring class action in the U.S. that same year and finalized an economic loss settlement the prior year.

GenHealth.ai builds out teams, extends agents with additional funding

BOSTON – GenHealth.ai has announced a $16.5 million Series A led by Flare Capital Partners, bringing its total funding to $30 million. Existing investors Craft Ventures and Obvious Ventures participated, along with new investors Eniac Ventures, InHealth Ventures, Epsilon Health Investors and ARTIS.

The company, which has grown to more than 20 employees, will use the funding to grow its engineering and go-to-market teams, extend its agents into additional workflows for provider groups and health plans, and continue improving the model underneath them.

"The problem with automating health care administration was never just the AI,” said Ricky Sahu, CEO and co-founder of GenHealth.ai. “It's that the AI is not connected to the systems providers already use, like the EHRs, plan portals, fax and bank accounts. At GenHealth we built those connections ourselves and created rails for workflows to run on, with context from our own model trained on 140 million patients. The result is patients getting care faster and providers getting paid over 30% more, which is unheard of in RCM."

GenHealth was founded in 2023 by Sahu and Ethan Siegel after Sahu's decade building interoperability APIs for the largest U.S. health plans at 1upHealth and CareJourney. The company’s agents are built on its Large Medical Model, a foundation model trained on the coded claims and clinical histories of more than 140 million patients.

The company says those agents run intake, eligibility verification, prior authorization, billing, denials and custom workflows end to end, inside the EHR, payer portals, fax and phone systems a customer already uses. It says its U.S.-based billing team handles exceptions, and staff stay in the loop for decisions that need judgment.

"We transitioned to GenHealth for full-service intake and billing and couldn't be happier," said Jack Bachman, CEO and Owner of Piedmont Medical Solutions. "By leveraging AI to make the process faster and easier, they've automated more work with better results than our previous outsourced team, which was five times their size. As a true partner that does not use offshore billing workers, they catch problems sooner and offer a level of transparency we never had before."

• Related: As CMS turns to AI, GenHealth.ai says it’s built for what’s next.

Medically Modern accelerates payer strategy with acquisition of Mid-Island Medical

NEW YORK – Medically Modern, a nationwide provider of continuous glucose monitors (CGMs), insulin pumps and related diabetes supplies, has acquired Wantagh, N.Y.-based Mid-Island Medical Supply, expanding the company’s insurance coverage from Medicare only to nearly every major commercial and public payer.

Through the transaction, Medically Modern acquired active payer contracts with Aetna, Cigna, Humana, Anthem Blue Cross Blue Shield, Fidelis Care, the NYSHIP Empire Plan, New York Medicaid and Horizon Blue Cross Blue Shield.

“Coverage is the whole game in this business,” said Corey Deutsch, founder and CEO of Medically Modern. “A patient can be prescribed a CGM by their doctor and still not get one because their plan isn’t in network with the supplier. This acquisition means we can say yes to far more of those patients.”

Medically Modern says it serves more than 2,000 patients across all 50 states, and its payer network now covers more than 85% of U.S. lives. The company says it helps patients verify coverage, work through prior authorization and other insurance requirements, and receive supplies at home.

Mid-Island Medical Supply has served patients since 1953, providing durable medical equipment (DME), mobility equipment, custom surgical compression garments, orthotics and post-mastectomy products. The business has been accredited by The Joint Commission since 1998.

Financial terms of the deal were not disclosed.

VGM seeks speakers for Heartland Conference

WATERLOO, Iowa – VGM is now accepting speaker proposals for the 2027 Heartland Conference, happening June 14-16, 2027, in Waterloo, Iowa. The conference offers the chance to connect with more than 1,000 professionals from across the country and make a lasting impact on the home medical equipment (HME), respiratory, and complex rehab technology (CRT) communities. Conference organizers are looking for dynamic speakers to deliver engaging sessions that provide relevant insights and fresh ideas that attendees can take back to their organizations. Topics of interest include:

• Billing & compliance
• Business operations
• Custom rehab technology
• Leadership & people strategy
• Respiratory
• Sales, marketing & retail
• Technology & security
• Integrated health & policy

To learn more about speaking at the Heartland Conference, visit: https://events.vgm.com/heartland/speak/cfsinformation. The deadline for submitting proposals is Oct. 31, 2026.

AADSM qualifies 2,500 dentists for OAT

LISLE, Ill. – The American Academy of Dental Sleep Medicine (AADSM) has announced that 2,500 dentists across the country have achieved AADSM Qualified Dentist status, strengthening patient access to oral appliance therapy (OAT) for obstructive sleep apnea (OSA). "Reaching 2,500 AADSM Qualified Dentists is an important milestone for patients who need convenient access to high-quality care close to home," said AADSM President Dr. Paul Jacobs. "Obstructive sleep apnea is a serious condition, and oral appliance therapy can be a comfortable and effective option for many patients. By expanding the number of qualified dentists available nationwide, we are helping more people connect with the care they need in their own communities." AADSM Qualified Dentists complete standardized education in dental sleep medicine that aligns with the AADSM's evidence-based standards for practice. These dentists are trained to provide OAT in coordination with physicians, supporting a team-based approach to treating OSA.

• Related: Daybreak joins Parachute, increasing access to therapy.

AdaptHealth appoints new CFO

PLYMOUTH MEETING, Pa. – AdaptHealth’s board of directors has named Harriss T. Currie as CFO. Currie will assume CFO responsibilities from Jason Clemens, who will assist with the transition through Oct. 1, 2026. Currie previously served as the CFO for Luminex Corp for more than 15 years until its sale to DiaSorin in 2021. He has more recently held CFO roles at Health Track Rx from 2025 to 2026 and Impulse Dynamics from 2022 to 2023. He also served as president of the Regenerative Medicine division of 3D Systems from 2023 to 2025. “We are delighted to welcome Harriss to AdaptHealth and look forward to the meaningful contributions we expect he will make in both the short and long term,” said Suzanne Foster, CEO. “We appreciate Jason’s years of service and are particularly thankful for the strong team and structure he has left for Harriss to build on.” Currie said he’s excited to join the company. “In evaluating this opportunity, I saw a strong leadership team, solid financial processes, and a business that has put strategic contracts in place to position itself for meaningful revenue and EBITDA growth,” he said.

• Related: AdaptHealth cites supplier, contract challenges in second-half outlook.

Stakeholders tee up CRT Awareness Week to push mobility act forward

LUBBOCK, Texas – NCART has announced CRT Awareness Week will take place Sept. 14-18 to promote the value that complex rehab technology (CRT) brings to the lives of individuals with disabilities. Each day, NCART will ask different stakeholders to use the NCART Voter Voice communication system to contact their U.S. senators to specifically support S. 247, The Choices for Increased Mobility Act. The act, which passed in the House of Representatives and awaits approval in the Senate, would improve access to carbon fiber and titanium manual wheelchairs. “It will be imperative for all of us to reach out to Senate offices to get this bill across the finish line,” the organization stated in an email bulletin. The act would create two new HCPCS codes: one for bases made with titanium or carbon fiber and another for bases made without those materials. It also would allow beneficiaries to upgrade within a code.

• Related: Social media surge amplifies CRT Awareness Week.

World Class Health adds home specialty infusion services

SAN FRANCISCO – World Class Health, a specialty care Centers of Excellence platform for self-insured employers, health plans and third-party administrators (TPAs), has expanded into specialty infusion, where it says site of care drives most costs. "Specialty infusion is one of the many health care purchases where members are flying blind on both their options and their cost," said Sid Nambiar, CEO of World Class Health. "A member who needs an infusion calls our team, gets the same treatment at home on their own schedule, and pays nothing, while their employer pays a fraction of the hospital price." According to World Class Health, specialty drugs account for roughly half of all pharmacy spend while being used by about 2% of patients, and gross specialty costs per member are projected to rise another 32% by 2028. The company says the same drug can cost several times more in a hospital outpatient suite than in a member's home, at an identical standard of care. WCH’s approach: The company’s care team identifies eligible members from claims and prior authorization data, confirms each member's out-of-pocket cost before treatment is scheduled and transitions care to a clinically appropriate home or suite setting. Its network delivers home infusion in all 50 states and includes hundreds of infusion suites for members whose therapy or preference calls for a facility.