The Centers for Medicare & Medicaid Services has identified and barred 11 durable medical equipment suppliers from receiving future Medicare payments over more than $3.4 billion in suspected fraudulent billing practices during 2025 and 2026, according to the agency.
The suppliers had submitted no claims prior to 2025 and used improper billing practices, including charges for equipment to deceased beneficiaries and supplies to beneficiaries who never requested or received them, CMS said. Four of the suppliers had already been revoked from Original Medicare and subsequently began billing Medicare Advantage plans instead.
All 11 suppliers submitted claims for deceased beneficiaries. In one case, a Florida-based company submitted approximately $18.4 million in catheter claims over two consecutive days in December 2025—$6.1 million for 500 beneficiaries on December 15 and $12.3 million for 777 beneficiaries the next day. CMS suspended the payments before they reached the supplier. A Texas-based company submitted approximately $5.5 million in orthotics claims before CMS similarly suspended payment. Investigators interviewed six beneficiaries in the Texas case who said they did not know the ordering providers, had never heard of the company, and did not need the equipment.
A New Jersey firm was placed on the CMS Preclusion List after billing a Medicare Advantage plan for 38 separate encounters in which the beneficiary was already deceased on the reported date of service. A Florida company is suspected of participating in a durable medical equipment telemarketing scheme involving oversupply of equipment, with beneficiaries reporting they did not receive items and were unfamiliar with the supplier.
CMS said it will continue working with the Department of Health and Human Services Office of Inspector General and other program integrity partners to identify suspicious billing and protect the Medicare Trust Fund.