# 119-hr-1785: Preventing Medicare Telefraud Act

119-hr-1785, Preventing Medicare Telefraud Act, is a 119th Congress bill sponsored by Rep. Doggett, Lloyd [D-TX-37] (D-TX); status introduced; PRIA reads it as touching household money (as of 2025-12-21).

- Canonical: https://policyrisk.com/legislation/119-hr-1785
- As of: 2025-12-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-1785
- Congress: 119
- Title: Preventing Medicare Telefraud Act
- Status: introduced
- Introduced: 2025-03-03
- Sponsor: Rep. Doggett, Lloyd [D-TX-37] (D-TX)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2025-12-21

## Summary

**Requires an in-person visit before Medicare will pay for high-cost durable medical equipment and high-cost laboratory tests ordered via telehealth.** It also forces providers to use their own National Provider Identifier for separately billable telehealth claims and sets up targeted audits for high telehealth-prescribing practitioners. - Patients: Patients must have at least one in-person visit with the ordering practitioner during the prior 6 months for Medicare to pay for these high-cost DME or lab tests ordered via telehealth. - Practitioners: Practitioners must submit separately billable telehealth claims under their own National Provider Identifier (NPI) or payment may not be made. - Program oversight: The Centers for Medicare & Medicaid Services will define which DME and lab tests are "high-cost." Medicare administrative contractors must begin identifying and auditing providers six months after enactment when at least 90 percent of a provider's DME or lab orders in the prior 12 months were issued via telehealth.

## Provisions PRIA read

- Medicare telehealth in-person rule for costly items and tests: mixed, high. If enacted, Medicare would not pay for high-cost equipment or lab tests ordered by telehealth unless the doctor saw you in person at least once in the prior 6 months. CMS would define which items and tests are high-cost. Starting 6 months after enactment, Medicare contractors would review the past…
- Provider ID needed for Medicare telehealth: mixed, low. Starting 180 days after enactment, Medicare would only pay for separately billed telehealth if the claim uses the doctor’s National Provider Identifier (NPI). If the provider uses the wrong ID, the claim could be denied until corrected. You could get a bill if Medicare does not pay.

## Related bills

- 119-hr-7977: Energy Bills Relief Act
- 119-hr-7973: Momnibus Act
- 119-hr-3971: Domestic Workers Bill of Rights Act
- 119-hr-3069: Medicare for All Act
- 119-hr-2913: Ukraine Support Act
- 119-hr-8839: Lainie Jones Comprehensive Cancer Survivorship Act of 2026

## Sources
- [119-hr-1785 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/1785)

## Related
- [119-hr-7977: Energy Bills Relief Act](https://policyrisk.com/legislation/119-hr-7977)
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-3971: Domestic Workers Bill of Rights Act](https://policyrisk.com/legislation/119-hr-3971)
- [119-hr-3069: Medicare for All Act](https://policyrisk.com/legislation/119-hr-3069)
- [119-hr-2913: Ukraine Support Act](https://policyrisk.com/legislation/119-hr-2913)
- [119-hr-8839: Lainie Jones Comprehensive Cancer Survivorship Act of 2026](https://policyrisk.com/legislation/119-hr-8839)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-1785 (as of 2025-12-21).