DME Scammer Prevention Act of 2026
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The DME Scammer Prevention Act of 2026 aims to reduce fraud and abuse within Medicare by requiring electronic submission of claims for certain medical equipment and supplies. It also mandates that claims for these items be submitted within 90 days of service. The bill directs the Comptroller General to report on the effectiveness of Medicare’s technology in identifying fraudulent claims and aberrant billing practices related to these items.
Key provisions
- Requires electronic submission of claims for specified medical equipment and supplies.
- Sets a 90-day deadline for submitting claims for these items.
- Defines ‘specified items’ as medical equipment and supplies furnished on or after January 1, 2027, listed on the Master List.
- Requires claims for applicable items to be submitted within 90 days of service, or the end of the following calendar year.
- Directs the Comptroller General to report on the use of technology to screen claims for fraud and abuse.
- The report will examine the number of claims initially denied and ultimately paid, as well as the basis for denials.
- Defines ‘applicable items’ to include specified items, excluding those on specific authorization lists.
- Establishes a reporting requirement for Medicare administrative contractors regarding their screening technology.
Who is affected
- Medicare beneficiaries
Bill text
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Sponsors
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1 on record
Primary sponsor
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