The Centers for Medicare & Medicaid Services (CMS) announced on Tuesday that it has barred 11 medical supply companies from participating in Medicare programs. The action targets entities responsible for over $3.4 billion in suspected fraudulent billing practices occurring in 2025 and 2026.
CMS identified that the barred suppliers engaged in improper billing, including claims for deceased beneficiaries and equipment supplied to individuals who never requested or received it. Four of the companies had previously been revoked from Original Medicare before billing Medicare Advantage plans.
Specific examples of the billing irregularities include:
- Florida Provider: Submitted approximately $18.4 million in catheter claims. On December 15, 2025, the provider billed $6.1 million for 500 beneficiaries, followed by $12.3 million for 777 beneficiaries the next day.
- Texas Company: Submitted about $5.5 million in orthotics claims. Six beneficiaries reported not knowing the ordering providers or needing orthotics, and nine claims had dates of service after the beneficiaries' deaths.
- New Jersey Firm: Billed Medicare for 38 encounters involving deceased beneficiaries.
CMS Administrator Dr. Mehmet Oz stated in a press release that the agency will not tolerate fraudsters who exploit recently deceased individuals. Oz emphasized that CMS is using advanced data analytics and payment safeguards to stop suspicious payments and protect the Medicare Trust Fund.
In a post on X, Dr. Oz added, "We're closing that door." The agency noted that it is coordinating with the HHS Office of Inspector General (HHS-OIG) to continue identifying suspicious billing patterns.
The crackdown comes amid broader scrutiny of healthcare fraud, including a lawsuit alleging that Medicare Advantage revenue was inflated through diagnoses. CMS has also targeted enrollment fraud in the ACA marketplace and highlighted fraud reduction and AI as tools to strengthen Medicare finances.
