The Centers for Medicare & Medicaid Services (CMS) is a department of Health and Human Services (HHS). The current administrator is Seema Verma, appointed by President Donald Trump.

CMS oversees the Medicare and Medicaid programs. CMS collects and analyzes data, produces research reports, and works to eliminate instances of fraud, waste and abuse within the health care system.

Legislation streamlines access to Medicare and Medicaid services for people eligible for both, ensuring older adults’ access to integrated care 

WASHINGTON—U.S. Senators Bill Cassidy, M.D. (R-LA), Tom Carper (D-DE), John Cornyn (R-TX), Mark Warner (D-VA), Tim Scott (R-SC) and Bob Menendez (D-NJ), members of the Senate Duals Working Group, introduced the Delivering Unified Access to Lifesaving Services (DUALS) Act of 2024 to improve coverage for individuals jointly enrolled in Medicare and Medicaid, also known as dual eligibles.

The DUALS Act of 2024:

It was alleged the home health agency violated the False Claims Act by submitting fraudulent claims to Medicaid for reimbursement

CHARLOTTE, North Carolina—Family First Home Health Care, Inc. (Family First), a home health care agency located in Gastonia, North Carolina, (now d/b/a Gaston Piedmont Health Care Inc.), and its owner Marion James have agreed to collectively pay $600,000 to resolve allegations that they knowingly violated the Federal and North Carolina False Claims Acts from Jan. 1, 2015, through Jan. 9, 2020, by submitting thousands of fraudulent claims to Medicaid for reimbursement, announced Dena J.

The pair conspired to commit Medicare fraud by billing for medically unnecessary DME such as knee, ankle, shoulder, wrist and back braces

SAN DIEGO—Anthony Duane Bell Sr. and his son, Anthony Duane Bell Jr., were sentenced in federal court to 65 months and 12 months and one day, respectively, for their roles in fraudulently receiving more than $21 million in Medicare payments and lying to cover it up.  

Steve Chicoye & conspirators were paid approximately $2.1M in kickbacks for DME orders, caused losses to Medicare & other health care benefit programs

TRENTON, New Jersey—A Florida man admitted his role in a durable medical equipment (DME) kickback scheme, U.S. Attorney Philip R. Sellinger announced.

Steve Chicoye, 55, of Orlando, Florida, pleaded guilty on Feb. 29, before U.S. District Judge Michael A. Shipp in Trenton federal court to an information charging him with one count of conspiracy to commit health care fraud.

According to documents filed in the case and statements made in court:

Fees for codes L8701 and L8702 are effective as of April 1, 2024

BOSTON—Myomo, Inc. (Myomo or the Company), a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis, today announced that on February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the final Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment rates for the MyoPro.

Thomas Andrew Webster pled guilty to conspiring to accept kickbacks in connection with a fraudulent telemarketing & medical supply scheme

SPOKANE, Washington—Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington, announced that Thomas Andrew Webster, M.D., age 51, of Sylvania, Ohio, pled guilty to conspiring to accept kickbacks in connection with a fraudulent telemarketing and medical supply scheme throughout Washington and in other states. District Judge Mary K. Dimke accepted Webster’s guilty plea and set sentencing for June 26 in Spokane, Washington. 

Steven Richardson agreed to plead guilty in connection with a fraud scheme involving medically unnecessary DME

BOSTON—The owner of Expansion Media (Expansion) and Hybrid Management Group (Hybrid) has been charged and has agreed to plead guilty in connection with a $110 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces. 

Lincare admitted it received reimbursements for claims that did not comply with billing rules & guidance

NEW YORK—According to the Department of Justice, Lincare, a durable medical equipment (DME) company, admitted that it received reimbursements for claims that did not comply with billing rules and guidance and continued to seek payments in instances when it was aware patients were not using the respiratory equipment.

Kareem Memon, who at the time of arrest was a felon, pleased guilty to health care fraud

NEWARK, New Jersey—A Florida man admitted his role in a multimillion-dollar durable medical equipment (DME) kickback scheme, Attorney for the United States Vikas Khanna, District of New Jersey and U.S. Attorney Markenzy Lapointe, Southern District of Florida, announced.

HHS & CMS are looking for comments related to all aspects of the MA program including access to care, PA, care quality and more

WASHINGTON—The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), released a Request for Information (RFI) to solicit feedback from the public on how best to enhance Medicare Advantage (MA) data capabilities and increase public transparency. 

Allegedly, Hillrom's direct to consumer division sold used Clinitron, TotalCare and VersaCare beds but billed federal health care programs as if they were new beds

COLUMBIA, South Carolina—Durable medical equipment (DME) companies Hill-Rom Holdings, Inc., Hill-Rom Company, Inc., Hill-Rom Services, Inc. and Advanced Respiratory Inc. (collectively, Hillrom) have agreed to pay $2.1 million to resolve allegations that the companies violated the False Claims Act by submitting false claims for payment to the Medicare, TRICARE, Department of Veterans Affairs and Medicaid programs.