Tag: Medicare
Program integrity: Timely filing change could be in play
October 16, 2026Liz Beaulieu, Editor
WASHINGTON – Home medical equipment (HME) providers are bracing for additional Medicare oversight measures as the Centers for Medicare & Medicaid Services (CMS) continues its efforts to combat fraud, waste and abuse, including a possible proposal that could impact timely filing requirements.
“We’re anticipating a new rule coming out that will touch us,” said Kim Brummett, senior vice president of regulatory affairs for AAHomecare. “We do think they’ve done a...
Bill introduced to pause competitive bidding for ostomy, urology supplies
October 9, 2026HME News Staff
WASHINGTON – Reps. Greg Murphy, R-N.C., and Brad Schneider, D-Ill., have introduced a bill that would exempt ostomy and urological supplies from Medicare’s DMEPOS competitive bidding program for five years.
According to AAHomecare, the Access to Medical Supplies Act would give the Centers for Medicare & Medicaid Services (CMS), with input from industry stakeholders, the time to fully analyze the impact of the program on patients.
The bill would:
Create a technical expert panel...
Industry, armed with data, ramps up advocacy for bid relief
October 2, 2026Theresa Flaherty
WASHINGTON – Home medical equipment (HME) stakeholders had several high-level meetings scheduled the week of Sept. 28, including with the Office of Management and Budget (OMB), to discuss the expected negative impact of the next round of Medicare’s competitive bidding program (CBP).
AAHomecare recently released the results of a survey that estimates more than 1,700 DMEPOS companies would be at risk of downsizing or closing down if a new remote-item delivery framework goes into effect...
CMS drops 750K from Federal Marketplace
September 23, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has cancelled approximately 315,000 unauthorized enrollments in the Federal Marketplace covering more than 760,000 individuals. The agency says this will return roughly $2.2 billion in taxpayer-funded subsidies.
“CMS is strengthening safeguards, pursuing bad actors, and holding agents and brokers accountable when they break the rules,” said HHS Secretary Robert F. Kennedy, Jr. “Under President Trump, HHS will...
Op-ed: Stop saying value based. Start saying earned
September 14, 2026Peter Falkson
Fifteen years of value-based care panels. Walk any trade show floor and you'll hear it a dozen times before lunch. Yet nearly every dollar in HME still moves the way it always has: per unit shipped, per month rented, whether the patient got better, got worse, or ever took the equipment out of the box.
I've stopped believing we're doing it wrong. I believe the structure of the payment system itself is the problem.
"Value-based" describes how a payment is calculated. "Earned"...
CMS adds 11 medical supply companies to Preclusion List
September 9, 2026HME News Staff
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:
Had submitted no claims prior to 2025
Used improper billing practices for their claims
Had...
Six-month enrollment moratorium ends
August 27, 2026HME News Staff
WASHINGTON – The six-month temporary moratorium on accepting Medicare supplier enrollment applications, which became effective on Feb. 27, 2026, has now expired as of Aug. 27, 2026.
The National Provider Enrollment (NPE) Contractors are once again accepting initial enrollment applications from durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers.
If you are planning to bid in Round 2028 of the DMEPOS Competitive Bidding Program (CBP), you should submit any...
OIG to CMS: Stronger fraud efforts are needed for DMEPOS
August 20, 2026HME News Staff
WASHINGTON – A new Office of Inspector General (OIG) white paper warns that durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fraud continues to cost Medicare and taxpayers millions of dollars annually despite increased oversight efforts.
The paper, “The Nation’s Challenge to Combat Durable Medical Equipment Fraud in Medicare,” focuses on three elements that bad actors need to commit fraud: a Medicare-enrolled supplier, a physician order and an enrollee...
CMS suspends more than 100 DME suppliers in fraud crackdown
July 23, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has suspended more than 100 DME suppliers and revoked the Medicare billing privileges of 725 suppliers as part of a broader effort to combat fraud in the program. CMS Administrator Mehmet Oz and Deputy Administrator Kimberly Brandt announced the enforcement actions during a July 9 press event, saying the suppliers had billed Medicare more than $1.5 billion. Brandt said the actions have “wiped out the majority of DME fraud...
Tactile to pay $550K to resolve false claims allegations
July 16, 2026HME News Staff
BOSTON – Tactile Systems Technology has agreed to pay $550,959 to resolve allegations that it submitted false Medicare claims for medically unnecessary pneumatic compression devices, according to the U.S. Attorney’s Office for the District of Massachusetts. Tactile markets the Entre and Flexitouch devices for patients with lymphedema and chronic venous insufficiency. Medicare covers pneumatic compression devices only after a patient fails to receive adequate relief following four weeks...