CMS/Medicare

HOUSTON—A 64-year-old man has been convicted of all counts as charged for leading a Medicare fraud scheme involving the submission of falsified medical records. The jury deliberated for less than two hours before convicting Paul Njoku following a three-day trial.

WASHINGTON—House Republicans passed the “One Big Beautiful Bill” on Thursday morning after an overnight session with a vote of 215 votes to 214. The sweeping bill is being criticized by homecare industry organizations, with some saying it could harm millions of older adults who rely on at-home care. 

ALEXANDRIA, Virginia & WASHINGTON—Ahead of the House Energy and Commerce Committee’s markup of proposed legislation impacting changes to the Medicaid program, aging and in-home care advocates urged Congress to protect Medicaid and preserve access to care. 

NEW YORK—Manishkumar Patel, 44, of Pelham Manor New York, was sentenced to 14 months in prison for defrauding Medicare of close to $50 million. Patel previously pled guilty to conspiring to commit health care fraud, wire fraud and violating the Anti-Kickback Statute.

WASHINTON—The Centers for Medicare & Medicaid Services (CMS) should delay its proposed national policy coverage determination (NCD) on noninvasive positive pressure ventilation (NIPPV) and make substantive changes or risk harming patient access, the American Association of Homecare said in public comments. 

NASHVILLE—Dr. John R. Manning, 64, of Ashland City, Tennessee, was sentenced to three years in federal prison for his participation in a health care fraud conspiracy, announced Acting United States Attorney Robert E. McGuire for the Middle District of Tennessee

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would update Mediare payment for hospices 2.4%—a figure industry advocates say is inadequate. 

WASHINGTON—As Dr. Mehmet Oz completes his first week as the 17th Administrator of the Centers for Medicare & Medicaid Services (CMS), he shared his agenda and vision for the agency in a press release. A cardiothoracic surgeon and former host "The Dr. Oz Show," he now leads the largest agency under the Department of Health and Human Services (HHS), with a $1.7 trillion budget, tasked with delivering health outcomes for more than 160 million people.

PHILADELPHIA—Patina, the virtual and in-home care provider, announced the launch of a new population health service called Patina Total Health (TM). The service provides personalized, age-friendly care and support to help Medicare Advantage plan members stay healthy, get the right care and more easily navigate their health care.

MIAMI—Manuel Delgado, 64, plead guilty to accepting cash bribes and self-dealing as part of a conspiracy to impede and obstruct the lawful functions of the U.S. Department of Health and Human Services (HHS) and the Center for Medicare and Medicaid Services (CMS) in their administration and oversight of the Medicare program.

WASHINGTON—United Cerebral Palsy (UCP) and ANCOR, two national voices for providers of long-term support services for people with intellectual and developmental disabilities (IDD), released the inaugural Case for Inclusion Policy Blueprint for Sustainable Services.

ALEXANDRIA, Virginia & WASHINGTON—The National Alliance for Care at Home (the Alliance) released the following statement on the Medicare Payment Advisory Commission’s (MedPAC) March 2025 Report to Congress: Medicare Payment Policy. MedPAC’s congressionally mandated report provides analysis and recommendations on various Medicare programs, including home health and hospice.

FARGO, North Dakota—Noridian Healthcare Solutions, LLC (Noridian), a developer of solutions for health care programs, announced the re-award of the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) Medicare Jurisdiction A (JA) contract.

WASHINGTON–A joint durable medical equipment Medicare Administrative contractor (DME MAC) publication announced new HCPCS codes for wheelchair accessories will go into effect on or after April 1, 2025. The Centers for Medicare & Medicaid (CMS) is revising HCPCS code E1028 and creating three new HCPCS codes for wheelchair accessories:

NEWARK, New Jersey—A Florida man was convicted by a federal jury for his role in a durable medical equipment (DME) kickback scheme that caused millions of dollars in losses to Medicare and other insurance providers.

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) announced its 2025 Quality Conference, which was scheduled for March 17-19, has been postponed. CMS said future conference dates will be announced at a later time. To stay up to date on information regarding the conference, visit cmsqualcon.com.

WASHINGTON—The American Association for Homecare (AAHomecare) announced that legislation to bolster rates for a large segment of home medical equipment (HME) suppliers has been reintroduced in the House of Representatives.

NEW YORK—Home medical equipment (HME) stakeholders in New York have worked with NYS Medicaid program leaders to adjust rates for standing frame/table systems that provide critical support for children with neuromuscular conditions that impair their ability to stand independently. 

The new rates apply as follows:

Chikao Tsubaki had been having a terrible time.

In his mid-80s, he had a stroke. Then lymphoma. Then prostate cancer. He was fatigued, isolated, not all that steady on his feet.

WASHINGTON—A Kansas man pleaded guilty to operating an internet-based platform that generated false doctors’ orders to defraud Medicare and other federal health care benefit programs of more than $1 billion.

WASHINGTON—A New York doctor was found guilty on Monday, Feb. 10 by a federal jury for causing the submission of more than $24 million in fraudulent claims to Medicare for medically unnecessary orthotic braces and laboratory tests.