Tag: Fraud
Telemedicine company owner sentenced in Medicare fraud scheme
July 2, 2026HME News Staff
WASHINGTON – The owner of two telemedicine companies has been sentenced to 10 years in prison and ordered to pay $66 million in restitution for her role in a scheme to fraudulently bill Medicare for medically unnecessary durable medical equipment (DME) and prescription drugs, the U.S. Department of Justice announced. “The defendant – nurse practitioner responsible for the care and safety of her patients – exploited our health care system, conspiring to submit over $136 million...
In brief: AO oversight finalized, Medicaid oversight tightened, scam campaign launched
June 19, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid (CMS) has published a rule finalizing enhanced oversight of accrediting organizations (AOs).
The agency says the rule, “Strengthening Oversight of AO and Preventing AO Conflicts of Interest,” ensures that the organizations responsible for the oversight of more than 9,000 health care providers and suppliers use Medicare standards, and creates greater consistency between State Survey Agencies (SAs) and AOs in their survey processes.
“The...
Florida launches Medicaid fraud crack down initiative
June 15, 2026HME News Staff
WEST PALM BEACH, Fla. – Florida Gov. Ron DeSantis has announced a Medicaid integrity initiative that includes enhanced provider screening, advanced fraud detection technology, enrollment controls for high-risk provider categories, and a statewide revalidation of all active Medicaid providers.
“In Florida, we work to ensure that taxpayer dollars are spent responsibly and that public programs serve the people they are intended to serve,” he said.
The Trump Administration and...
In brief: Medline responds to fire, former Drive execs return to HME, Florida cracks down
June 12, 2026HME News Staff
TRACY, Calif. – Medline is prioritizing supporting its team after a fire impacted its distribution facility in Tracy, Calif., on June 11.
The company says all employees and on-site personnel have been safely evacuated and accounted for.
“We have connected with nearly all affected employees and are offering onsite and local support, resources including financial support and counseling services, and continued communication as we work through next steps together,” the company...
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...