The Centers for Medicare & Medicaid Services (CMS) is a department of Health and Human Services (HHS). The current administrator is Seema Verma, appointed by President Donald Trump.
CMS oversees the Medicare and Medicaid programs. CMS collects and analyzes data, produces research reports, and works to eliminate instances of fraud, waste and abuse within the health care system.
LOUISVILLE, Kentucky—A former Kentucky resident was sentenced last week to two years and nine months in federal prison for engaging in a conspiracy to commit health care fraud in connection with durable medical equipment businesses.
WASHINGTON—The Department of Health and Human Services (HHS) released more details on the agency’s budget request for the 2026 fiscal year in its 51-page Budget in Brief, along with a 194-page Justification of Estimates for Appropriations Committees for the Centers for Medicare and Medicaid Services (CMS).
OWINGS MILLS, Maryland—The Board of Certification/Accreditation (BOC), a CMS-deemed accrediting organization serving the durable medical equipment, orthotics, prosthetics and supplies (DMEPOS) industries for more than 40 years, shared updates regarding a three-year cessation in accepting new accreditation and reaccreditation applications in four states: Florida, Texas, California and New York.
BOSTON, Massachusetts—The owner of Pharmagears, LLC (Pharmagears) and RR Medco, LLC (RR Medco) has agreed to plead guilty in connection with a nearly $30 million health care fraud conspiracy involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces.
SAN DIEGO, California—Chula Vista resident and businessowner Fernando Valenzuela Ayub pleaded guilty in federal court, admitting that he conspired with others to launder millions of dollars of health care fraud proceeds and paid unlawful kickbacks.
BALTIMORE, Maryland—The Centers for Medicare & Medicaid Services (CMS) announced a significant expansion of its auditing efforts for Medicare Advantage (MA) plans. Beginning immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.
ALEXANDRIA, Virginia—Three people have been sentenced to prison for their roles in a multi-million-dollar Medicare billing scheme.
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:
