Legal: Take steps now to update compliance

Q. How can DMEPOS suppliers prepare for new compliance requirements that may arise from the CRUSH Request for Information?

A. In early 2026, CMS issued a Request for Information (RFI) to solicit recommendations and information from industry participants and other stakeholders to bolster the Trump administration’s Comprehensive Regulations to Uncover Suspicious Healthcare (“CRUSH”) initiative. The CRUSH RFI sought input “…on ways to strengthen CMS’s ability to prevent, detect, and respond to fraud, waste, and abuse, and program inefficiencies in Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.” The comment period for the CRUSH RFI has ended, and though CMS has not yet published a final rule related to the RFI findings, the RFI itself reveals several areas, including program integrity and ownership disclosure requirements where the compliance framework is likely to change for HME suppliers.

Though the exact compliance criteria under CRUSH remain unclear, HME suppliers should review their existing compliance programs to determine what changes, if any, should be made in anticipation of the final rule regarding the CRUSH RFI. Based on a sampling of the key topics raised by the CRUSH RFI, a Medicare-enrolled HME supplier can take early steps to prepare for compliance with any final rule by ensuring:

• It conducts regular internal audits of its claim submissions and reimbursements for compliance with Medicare guidelines, and contemporaneously documents any favorable or unfavorable findings;
• It has policies in place to address, escalate, and report to CMS/OIG, if necessary, any problematic claims or overpayments received;
• All ownership/controlling interest disclosures are current, accurate and complete; and
• It has a plan in place to comply with additional fingerprinting/additional background check requirements or citizenship/residency requirements, should CMS impose such requirements for disclosable ownership and controlling interests.

While it remains unclear how the concerns raised in the CRUSH RFI will, ultimately, be addressed, a final rule imposing new compliance requirements is almost certainly on the horizon. By reviewing the compliance concerns highlighted in the RFIs now, HME suppliers will be prepared to act quickly to update their compliance programs with any new requirements.

Kianna L. Sitarski, Esq., is a member of the Health Care Group at Brown & Fortunato, PC, a law firm with a national health care practice based in Texas. She represents pharmacies, infusion companies, HME companies, manufacturers, and other health care providers throughout the United States. Ms. Sitarski can be reached at (972) 684-5788 or ksitarski@bf-law.com.