HHS Moves to Tackle Suspicious Billing of Medical Equipment

The Biden administration issued a final rule Tuesday designed to address suspicious billing for durable medical equipment that may have cost the Medicare program more than $2 billion.

The problem involving urinary catheters has disproportionately affected accountable care organizations, the groups of doctors, clinicians, and hospitals that provide coordinated care for beneficiaries in traditional Medicare.

After detecting the spike in billing in early 2023, the Centers for Medicare & Medicaid Services stopped payment on almost all of the claims, and began an investigation.

They found the activity “was attributed to a small group of durable medical equipment supply companies,” and ...