Tag: Claims Processing
Rep. Bean targets ‘DME scammers’ with new bill
May 26, 2026HME News Staff
WASHINGTON – Rep. Aaron Bean, R-Fla., has introduced H.R. 8871, the DME Scammer Prevention Act, to require the electronic submission of DME products most susceptible to fraud within 90 days of the initial claim date. The current submission deadline is 365 days, which Bean says allows fraudulent vendors to take advantage of the payment system. “Rising fraud and criminal activity threaten to undermine the Medicare system for Northeast Floridians and seniors across the country,” he...
CMS to MACs: Lift claims hold
October 28, 2025HME News Staff
WASHINGTON – CMS has instructed all Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with dates of service Oct. 1, 2025, and later for certain services impacted by select expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act of 2025.
This includes claims paid under the:
Medicare Physician Fee Schedule
Ground ambulance transport
Federally Qualified Health...