DME Scammer Prevention Act of 2026
Sponsored By: Representative Bean, Aaron [R-FL-4]
In Committee
Summary
Strengthen Medicare payment integrity for medical equipment and supplies. It would require electronic claims for many specified items, set a 90-day claims window for certain supplies, and mandate oversight of contractors' screening technology.
Show full summary
- Providers and suppliers would have to submit electronic claims for "specified items" (medical equipment and supplies) furnished on or after January 1, 2027. They would also face a 90-day deadline to file claims for applicable items, though some items on targeted regulatory lists and monthly rentals are excluded.
- Medicare administrative contractors and oversight bodies would be the focus of a Comptroller General report due January 1, 2030 that evaluates the technology contractors use to screen claims. The review must consider the one-year period starting January 1, 2027 and how screening identifies waste, fraud, or abuse.
- The bill creates a forward-looking framework tied to the Master List and regulatory lists to identify and manage specified items and to streamline electronic submission. The aim is to tighten payment integrity for medical equipment and supplies.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
New Medicare billing rules for medical equipment
If enacted, this would change how Medicare handles claims for certain medical equipment and supplies. Suppliers would not have to submit claims electronically for items furnished on or after January 1, 2027 that are on the Medicare Master List. The bill would also set a 90-day deadline to file claims for applicable items. The 90-day rule would not apply to items that require a face-to-face visit (42 C.F.R. 410.38(c)(8)), items on the prior-authorization list (42 C.F.R. 414.234(c)(1)), or items paid as monthly rentals.
Sponsors & CoSponsors
Sponsor
Bean, Aaron [R-FL-4]
FL • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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