DME Fraud Prosecutions Top $1.5B in Sentences Since May
Becker's Hospital Review reports that federal prosecutors have secured guilty pleas or prison sentences in at least six durable medical equipment fraud cases tied to more than $1.5 billion in claims since late May, while CMS has barred 11 DME suppliers from Medicare Advantage and Part D payments. The schemes follow a consistent pattern: telemarketers target elderly beneficiaries, practitioners sign orders for orthotic braces or other DME without examining patients, and suppliers bill Medicare and Medicare Advantage plans for unneeded equipment. CMS had also imposed a six-month moratorium on new DMEPOS enrollment earlier in 2025, citing more than $1.5 billion in suspected fraudulent billing, which expired in August. DME schemes also featured prominently in the Justice Department's 2026 National Health Care Fraud Takedown, which charged 455 defendants tied to more than $6.5 billion in alleged false claims.