WASHINGTON, D.C.. – Last week CMS announced new initiatives to deter criminal elements from abusing the Medicare benefit by posing as legitimate DMEPOS suppliers. These efforts include a six-month moratorium on new DMEPOS enrollments for these seven supplier types:
• Medical supply company
• Medical supply company with orthotics personnel
• Medical supply company with pedorthic personnel
• Medical supply company with prosthetics personnel
• Medical supply company with prosthetic and orthotic personnel
• Medical supply company with registered pharmacist
• Medical supply company with respiratory therapist.
The moratorium also includes new locations for existing suppliers and applies throughout the United States, including all states, territories, and the District of Columbia. The effective date of this notice is February 27, 2025.
“We appreciate CMS Administrator Oz’s demonstrated commitment to preventing criminals from enrolling in the DMEPOS program,” remarked Josh Marx, CEO of Medical Service Company and chairman of the Board for AAHomecare. “We hope to work with CMS to strengthen enrollment practices without harming patients and communities by mandating a complete halt to new enrollments for existing providers.”
CMS Seeks Stakeholder Input to Strengthen Defenses Against Fraud
The announcement also notes that CMS is “looking to stakeholders to provide input, based on their experience and knowledge, on additional ways the agency can tackle fraud prevention to help inform the development of a possible future rule” under the Agency’s new Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative.
As a first step in this effort, CMS is issuing a Request for Information (RFI) on ways the Agency can strengthen defenses against Medicare fraud, seeking input from a broad range of stakeholders – including states, providers, suppliers, payers, technology companies, patient advocates, and beneficiaries. CMS suggests that a proposed rule may follow and be informed by responses to their RFI.
DMEPOS Suppliers Committed to Crush Fraud
“DMEPOS suppliers and other industry stakeholders are 100% supportive of a comprehensive approach to keep criminal elements from abusing the Medicare program,” said Tom Ryan, AAHomecare president & CEO. “The direct costs of fraud as well as the government resources expended to pursue and prosecute bad actors take away from resources that could be used to keep more Americans healthy and able to contribute to their communities.”
“Leveraging new technology to detect unusual billing patterns and better approaches to keep criminal enterprises from enrolling in the Medicare program are absolutely essential to this effort,” added Ryan. “The DMEPOS community is committed to working with the Trump Administration and CMS on lasting solutions to crush Medicare fraud once and for all.”
AAHomecare will share additional perspective on the new initiative and guidance on responding to the RFI. Comments to RFIs are usually due 30 days after publication in the Federal Register. CMS has shared a March 20 deadline for RFI comments; AAHomecare will notify its membership once it receives a clarification on this issue.
