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.

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.

Jeffrey Brooks was charged with conspiring to submit or cause to be submitted false and fraudulent claims to Medicare

GREENVILLE, South Carolina—Jeffrey Brooks, 40, of Clarence Center, New York, was sentenced to more than seven years in federal prison after pleading guilty to one count of conspiracy to commit health care fraud. In addition to Brooks’ criminal conviction, last year, Brooks paid $850,000 in a civil settlement to resolve allegations that he provided kickbacks and caused false claims to be submitted in violation of the federal False Claims Act.

Jerry Bruggeman was alleged to have provided false statements regarding Medicare beneficiaries who received medical devices

KANSAS CITY, Missouri—A Columbia, Missouri physician has been indicted by a federal grand jury for making false statements relating to Medicare orders.

Jerry Joseph Bruggeman, 52, was charged in a 13-count indictment returned by a federal grand jury in Kansas City, Missouri, on Tuesday, Jan. 23.

Atlantic Home Health Care allegedly falsely billed the Energy Program for in-home nursing and personal care when its employees were not physically present in patients’ homes

ARIZONA—Atlantic Home Health Care LLC (AHH), a home health care agency operating in Arizona and eight other states, has agreed to pay $9,990,944 to resolve allegations that it violated the False Claims Act by submitting false claims to the Energy Employees Occupational Illness Compensation Program (EEOICP or the Energy Program), a health care program administered by the Department of Labor (DOL) for the benefit of Department of Energy employees and contractors with occupational illnesses.

As MA private plans increase in enrolled numbers, so have concerns about the insurer's sales tactics and misleading coverage claims

This story is republished from KFF Health News—a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Elizabeth Hernandez submitted claims for genetic tests, DME that weren't needed and telemedicine visits that never occured

MIAMI—A Florida woman was sentenced to 20 years in prison for her role in a scheme to defraud Medicare by submitting more than $192 million in claims for genetic tests and durable medical equipment that patients did not need and telemedicine visits that never occurred. 

NEW YORK—Damian Williams, the United States Attorney for the Southern District of New York, and Naomi Gruchacz, the Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services - Office of Inspector General (HHS-OIG), announced the arrests of Erin Foley and Ted Albin on charges of health care fraud and conspiracy to violate the Anti-Kickback Statute.