WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services barred 11 medical-equipment suppliers from future Medicare Advantage and Part D payments after identifying more than $3.4 billion in suspected fraudulent billing during 2025 and 2026, including claims involving beneficiaries who had already died.
The durable medical equipment, prosthetics, orthotics and supplies companies had submitted no Medicare claims before 2025, according to CMS. The agency said the suppliers used improper billing practices and submitted claims for equipment that beneficiaries did not request or receive.
All 11 suppliers billed Medicare for multiple beneficiaries who were deceased, CMS said. Four had previously been revoked from Original Medicare and subsequently began billing Medicare Advantage plans.
CMS, working with the Department of Health and Human Services Office of Inspector General, placed the suppliers on its Preclusion List after determining their conduct was detrimental to the Medicare program. Placement on the list prevents payment for Medicare Advantage items and services and Part D drugs furnished or prescribed to beneficiaries.
The agency said it blocked nearly $24 million in payments tied to two suppliers using its Original Medicare payment-suspension authority.
A Florida-based supplier submitted about $18.4 million in catheter claims over two consecutive days in December 2025. The company billed $6.1 million for 500 beneficiaries on Dec. 15 and another $12.3 million for 777 beneficiaries the following day, according to CMS.
CMS suspended the payments before they reached the supplier.
A Texas-based company separately submitted about $5.5 million in orthotics claims. CMS said six beneficiaries interviewed by investigators did not know the ordering providers or the supplier and reported that they did not need the orthotics.
The agency also identified claims from that supplier for nine beneficiaries with dates of service after their deaths and determined that the company was not operating at its reported location. CMS suspended those payments as well.
A New Jersey-based supplier was placed on the Preclusion List after billing a Medicare Advantage plan for 38 encounters in which beneficiaries were already dead on the reported service dates. CMS also received complaints from members who said they did not know the providers involved and had not requested or needed the equipment.
Another Florida supplier is suspected by CMS of participating in a telemarketing operation involving excess medical equipment. Several beneficiaries reported that they never received braces for which the company billed and were unfamiliar with the supplier.
CMS Administrator Mehmet Oz said the agency is using data analytics and payment controls to identify potentially fraudulent networks and “stop suspicious payments before the check clears.”
The enforcement action combines payment suspensions, supplier enrollment authorities and the Medicare Preclusion List as CMS and HHS investigators seek to prevent questionable claims from generating additional federal payments.
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