WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has added eight HCPCS codes to the list of those requring prior authorization for Medicare billing, including a bed, a wheelchair and several orthoses.
WASHINGTON—The United States Department of Health and Human Services Office of Inspector General (OIG) recently determined that there is more that could be done by the Centers for Medicare & Medicaid Services to prevent durable medical equipment, prosthetics and orthotics supplies (DMEPOS) fraud in Medicare Advantage.
WATERLOO, Iowa—VGM Insurance announced that it is ready to provide the $100,000 bid surety bond required by the Centers for Medicare & Medicaid Services (CMS) for the upcoming durable medical equipment, prosthetics and orthotics supplies competitive bidding program round in 2028.
The company said this offering gives home medical equipment (HME) and orthotic and prosthetic (O&P) suppliers the support they need to participate in the next round of bidding with confidence.
WASHINGTON—Centers for Medicare & Medicaid Services (CMS) announced it has identified and is barring 11 medical supply companies with more than $3.4 billion in suspected fraudulent billing practices in 2025 and 2026 from receiving future Medicare Advantage (MA) Part C and Part D payments.
These 11 durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) suppliers allegedly:
ALEXANDRIA, Virginia—While next year's planned home health Medicare rates do include a welcome full annual payment update, the overall proposed rule doesn't do enough to undo prior harm or protect access to care across the country, the National Alliance for Care at Home said in public comments on the rule.
SAN FRANCISCO—Hike Medical, the company automating device-based care from referral to dispense, has raised $22.5 million in seed and Series A funding to reimagine the entire supply chain for durable medical equipment, prosthetics and orthotics supplies (DMEPOS).
WASHINGTON—In a recently published report, the Department of Health and Human Services Office of Inspector General (OIG) said the Centers for Medicare & Medicaid Services (CMS) should take "bold action" to prevent durable medical equipment (DME) fraud, making recommendations that include tightening Medicaid enrollment for providers, collaborating with physicians and using new technologies like AI.
WASHINGTON—The Choices for Increased Mobility Act (HR 1703), passed the United States House of Representatives by voice vote, advancing the legislation to the Senate.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) is recommending adding a new “country of origin" field as a requirement for lead items provided by durable medical equipment (DME) suppliers chosen for the agency’s Medicare competitive bidding program.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has announced that, effective May 8, 2026, Chags Health Information Technology LLC (C-HIT) will no longer handle durable medical equipment, prosthetics and orthotics supplies (DMEPOS) appeals and rebuttals. Responsibility for processing these submissions will transition to the National Provider Enrollment (NPE) DMEPOS contractors.
The American Association for Homecare (AAHomecare) said that for suppliers this means:
WASHINGTON—The American Academy of Sleep Medicine (AASM) recently sent a letter to UnitedHealthcare, raising concerns about the use of Synapse Health for durable medical equipment (DME) fulfillment for continuous positive air pressure (CPAP) therapy. The letter outlined member‑reported issues affecting patient access to care and clinical workflows.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) is proposing an additional change to the durable medical equipment, prosthetics & orthotics services competitive bidding program (DMEPOS CBP).
WATERLOO, Iowa—VGM & Associates announced that Matt Filippis has been named director of business development for clinical mobility and accessibility. In this role, Filippis will focus on executing the business development strategy to drive growth and profitability for the clinical mobility and accessibility membership channels, including U.S. Rehab, VGM Live at Home and OPGA.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) released a proposed local coverage determination (LCD) for a not reasonable and necessary determination for Group 2 power wheelchairs (PWCs) with seat elevation systems (K0830 and K0831) based on the best available evidence.
WATERLOO, Iowa—VGM & Associates announced it has released a new playbook aimed towards guiding VGM members through the upcoming changes and trends in the home medical equipment (HME) and durable medical equipment, prosthetics and orthotics supplies (DMEPOS) industry.
WATERLOO, Iowa—The Healthcare Quality Association on Accreditation (HQAA) announced the appointment of Craig Douglas as its next executive director, succeeding Rhonda Pearce, who is retiring after 21 years of dedicated leadership and service to the organization.
WASHINGTON—Earlier this week, the Centers for Medicare & Medicaid Services (CMS) updated several lists that cover durable medical equipment (DME) reimbursement authorization. The three lists updated were the required face-to-face and written order prior to delivery list (Required F2F/WOPD), the required prior authorization list and the master list.
TROY, Michigan—Integra Partners announced it has entered a partnership with HelixVM, a provider of 24/7 "visit-less" asynchronous virtual care, under its group purchasing organization (GPO) offer. The partnership tackles one of the biggest challenges in the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) industry-getting the documentation and medical orders required to bill for services.
ARLINGTON, Virginia—Community Health Accreditation Partner (CHAP) has announced the appointment of Timothy Safley as strategic advisor to its durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) program. Safley brings more than three decades of leadership across DMEPOS, specialty and infusion pharmacy and home health/hospice, including senior roles in national provider operations and the development of accreditation programs at a national accrediting organization.
