CMS/Medicare

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) announced resources and flexibilities to support individuals and health care providers affected by the severe storms, straight-line winds and flooding in Texas.

WASHINGTON—On the heels of revealing a huge federal fraud takedown operation, the current administration has made another move, indicating it is taking a hard line on health care fraud.

WASHINGTON—The Centers for Medicare & Medicaid (CMS) released a proposed rule on home health and durable medical equipment (DME) that includes new provisions for the next implementation of the Competitive Bidding Program (CBP), the American Association for Homecare (AAHomeCare) shared in an email with its members. 

Editor's note: This story was updated July 1, 2025 with additional industry reactions. 

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on Monday, June 30, that would permanently reduce home health payment rates by 4.059% in 2026 and add a temporary 5% clawback as well.

WASHINGTON—Sen. Marsha Blackburn and Sen. Susan Collins submitted a letter to Centers for Medicare & Medicaid (CMS) Administrator Dr. Mehmet Oz expressing concern for the future of the Medicare home health benefit, including continued payment cuts leading to further agency closures in their communities.

WASHINGTON—Top United States health insurance providers pledged to streamline and improve the prior authorization processes for Medicare Advantage, Medicaid Managed Care, Health Insurance Marketplace and commercial plans covering nearly eight out of 10 Americans, Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced on Monday, June 23. 

Responding to charges that President Donald Trump’s tax and spending bill would cut Medicaid coverage for millions of Americans, Trump administration officials misleadingly counter that it targets only waste, fraud and abuse.

WASHINGTON—In its recently released budget documents, the Department of Health and Human Services (HHS) has indicated that the Centers for Medicare & Medicaid Services (CMS) is likely to start the next round of competitive bidding. 

WISCONSIN—Michael G.V. Comino was sentenced to 22 months; imprisonment for conspiracy to pay and receive health care kickbacks in violation of the Anti-Kickback Statute. Comino was also ordered to pay over $2 million in restitution to Medicare.

TEMPE, Arizona—PocketRN, a provider of virtual nursing care, and SYNERGY HomeCare, a homecare company, announced they will form a national partnership to test the Centers for Medicare & Medicaid Services (CMS) alternative payment model designed to support people living with dementia and their family caregivers. 

NEW YORK—According to AAHomecare, the New York Senate passed long-sought Medicaid rate floor legislation, S 1616, on a unanimous vote. The State Assembly affirmed a companion bill (A2520) earlier in the week, also by a unanimous tally.

BALTIMORE, Maryland—The Centers for Medicare & Medicaid Services (CMS) announced it has released its final national coverage determination (NCD) for the treatment of chronic respiratory failure associated with chronic obstructive pulmonary disease (COPD).

WASHINGTON—A federal jury convicted the CEO of Power Mobility Doctor Rx, LLC (DMERx) for his role in operating a platform that generated false doctors’ orders to defraud Medicare and other federal health care benefit programs of more than $1 billion.

ST. PAUL, Minnesota—High school senior Joshua Yang understands sacrifice. When he was midway through 10th grade, his mom survived a terrible car crash. But her body developed tremors, and she lost mobility. After countless appointments, doctors diagnosed her with Parkinson’s disease, saying it was likely triggered by brain injuries sustained in the wreck.

At 15, Yang, an aspiring baseball player and member of his school’s debate team, took on a new role: his mother’s caregiver.

NEW YORK—A Florida man who allegedly sold fake prescriptions for durable medical equipment prescriptions was sentenced to 42 months in prison. 

WASHINGTON—Following the recent release of the Health Technology Ecosystem request for information (RFI), the Centers for Medicare & Medicaid Services (CMS) hosted an in-person listening session to discuss the RFI and ways to use the health technology innovations to enhance patient care and promote efficiencies in the health care system.

LOUISVILLE, Kentucky—A former Kentucky resident was sentenced last week to two years and nine months in federal prison for engaging in a conspiracy to commit health care fraud in connection with durable medical equipment businesses.    

WASHINGTON—The Department of Health and Human Services (HHS) released more details on the agency’s budget request for the 2026 fiscal year in its 51-page Budget in Brief, along with a 194-page Justification of Estimates for Appropriations Committees for the Centers for Medicare and Medicaid Services (CMS).

OWINGS MILLS, Maryland—The Board of Certification/Accreditation (BOC), a CMS-deemed accrediting organization serving the durable medical equipment, orthotics, prosthetics and supplies (DMEPOS) industries for more than 40 years, shared updates regarding a three-year cessation in accepting new accreditation and reaccreditation applications in four states: Florida, Texas, California and New York.

BOSTON, Massachusetts—The owner of Pharmagears, LLC (Pharmagears) and RR Medco, LLC (RR Medco) has agreed to plead guilty in connection with a nearly $30 million health care fraud conspiracy involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces.

SAN DIEGO, California—Chula Vista resident and businessowner Fernando Valenzuela Ayub pleaded guilty in federal court, admitting that he conspired with others to launder millions of dollars of health care fraud proceeds and paid unlawful kickbacks.