Tag: Fraud
Ohio Gov. DeWine signs executive order aimed at Medicaid fraud
May 20, 2026HME News Staff
COLUMBUS, Ohio – Ohio Gov. Mike DeWine has signed Executive Order 2026-01D to allow the Ohio Department of Medicaid (ODM) to implement emergency rules to require more frequent revalidation of providers identified as higher-risk for committing fraud.
Additionally, DeWine sent a letter to the Centers for Medicare & Medicaid Services (CMS) on May 1 committing Ohio to partnering with the Trump Administration and using a more stringent revalidation process to better prevent fraud.
Under...
Oz announces new nationwide Medicaid anti-fraud effort coming, but offers no details
April 28, 2026HME News Staff
WASHINGTON – Dr. Mehmet Oz announced last week that all 50 states will be required to explain their plans to revalidate some of their Medicaid providers.
Oz, Centers for Medicare & Medicaid (CMS) Administrator, made the announcement April 21 during a health care summit hosted by Politico. In the announcement, Oz said that the CMS will ask states to share their strategies within 30 days, according to several online news reports.
"It's an example of what we'd like them to do...
In brief: AARP’s fraud recommendations, sleep’s communications breakdown, Purtill’s new role
April 3, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) should invest more in oversight and enforcement of program integrity as it seeks to curb fraud, waste and abuse, says the AARP.
The recommendation was one of several that the AARP included in its response to the agency’s RFI for “Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).”
Other AARP recommendations include:
Strictly enforcing existing regulations on accrediting...
AARP submits recommendation to CRUSH fraud
April 2, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) should invest more in oversight and enforcement of program integrity as it seeks to curb fraud, waste and abuse, says the AARP.
The recommendation was one of several that the AARP included in its response to the agency’s RFI for “Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).”
Other AARP recommendations include:
Strictly enforcing existing regulations on accrediting...
Department of Treasury wants to pay for information on fraud
March 31, 2026HME News Staff
WASHINGTON – The U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) on March 30 issued a proposed rule paving the way to pay whistleblowers for actionable tips on fraud schemes targeting government health care benefit programs such as Medicare and Medicaid.
“As promised, Treasury will reward whistleblowers who provide timely, actionable information on fraud, sanctions violations, and other significant illicit finance activity,” said Secretary...
Florida Medicaid also issues moratorium on new DME providers
March 30, 2026HME News Staff
TALLAHASSEE, Fla. – The Agency for Health Care Administration announced on March 26 that it has issued a temporary moratorium for the enrollment of new durable medical equipment (DME) providers in the Florida Medicaid system. The agency says the moratorium will combat fraud and safeguard taxpayer dollars, while ensuring quality access to care.
The moratorium will remain in place for an initial six-month period.
“The agency is continually looking at ways to strengthen fraud detection...
Senators urge Trump administration to stop ‘phony crusade’ against fraud
March 30, 2026HME News Staff
WASHINGTON – U.S. Sens. Ron Wyden, D-Ore., and Jeff Merkley, D-Ore., in a March 26 letter demanded that President Donald Trump stop what they call his “phony crusade against fraud as a disguise to attack Medicaid programs in U.S.”
“Let us be clear: You are not going after the real fraudsters,” the senators said. “Instead, under the guise of ‘program integrity,’ you are cutting off vital funding for services that seniors, people with disabilities,...
In brief: CMS modernizes, hospital-at-home scales, fraud dragnet widens
March 30, 2026HME News Staff
WASHINGTON – The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have announced the members of a Healthcare Advisory Committee to provide advice on improving, strengthening and modernizing health care.
The committee will advise HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz on ways to improve how care is financed and delivered across Medicare, Medicaid, the Children’s Health Insurance Program and the...
HME’s two-part challenge: Report fraud, tell story
March 27, 2026Liz Beaulieu, Editor
WATERLOO, Iowa – VGM Government Relations has reintroduced a fraud resource center to make it easier for industry stakeholders to help remove bad actors from the home medical equipment (HME) industry. But Ike Isaacson, senior vice president of government and regulatory relations, wants to be clear: The industry wants to not only acknowledge fraud in the Medicare program but also recognize the good actors that make up most of the industry.
HME News: The Centers for Medicare & Medicaid Services...
Doc sentenced in telemedicine scheme, ordered to pay restitution
March 25, 2026HME News Staff
BOSTON – An Alabama-based doctor has been sentenced to 16 months in prison for a $2.7 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME) and genetic testing primarily used to detect mutations in genes that could indicate a higher risk of developing certain types of cancers. Tommie Robinson, 44, was sentenced on March 20 by U.S. Senior District Court Judge Nathaniel M. Gorton in Boston. Robinson was also ordered to pay $2,784,733.49...