DME Scammer Prevention Act of 2026
This bill establishes requirements relating to potentially fraudulent billing for certain durable medical equipment under Medicare.
Specifically, the bill establishes requirements relating to billing for items that are on the Master List of Durable Medical Equipment, Prosthetics, Orthotics and Supplies. (The master list includes items that the Centers for Medicare & Medicaid Services has identified as posing certain fiscal vulnerabilities and therefore require additional conditions for payments to be made, such as prior authorization.)
The bill requires claims for such items to be filed electronically and within 90 days of when the items were furnished. The Government Accountability Office must report on the technology used by Medicare administrative contractors to identify fraudulent claims with respect to such items.