CMS/Medicare

DULUTH, Minnesota—The Midwest Association for Medical Equipment Services and Supplies (MAMES) has increased advocation for enhanced coverage of breast pumps and lactation services in Nebraska. Working closely with the Nebraska Medicaid director, the company said it aims to implement these effective, beneficial changes. Additionally, the new coverages seek to align with other Medicaid programs in the Midwest. 

NEW ORLEANS—U.S. Attorney Duane Evans announced that Robert Lake, a resident of East Rockaway, New York, was arrested in the Dallas Fort Worth International Airport after disembarking from an international flight. Lake was previously indicted for federal health care fraud on Oct. 18, 2025, for one count of conspiracy to commit health care fraud and three counts of health care fraud.

WASHINGTON—The National Alliance for Care at Home (The Alliance) submitted comments on the proposed Centers for Medicare & Medicaid Services (CMS) contract year 2026 policy and technical changes to Medicare Advantage (MA) programs.

WASHINGTON—Petros Fichidzhyan, a California man, pleaded guilty to health care fraud, aggravated identity theft and money laundering in connection with scheme to defraud Medicare of more than $17 million through sham hospice companies and his home health care company, according to the U.S. Department of Justice. Fichidzhyan is scheduled to be sentenced on April 14.

NASHVILLE, Tennessee—The Durable Medical Equipment Medical Administrative Contractors (DME MACs) have released a joint publication reminder in response to questions on drug coverages for nebulizers and external infusion pump local coverage determinations (LCDs).

WASHINGTON—The Centers for Medicare and Medicaid Services (CMS) issued a revised policy (CR 13049) that seeks to update documentation requirements for replacement supplies of beneficiary-owned continuous glucose monitors (CGMs), the American Association for Homecare (AAHomecare) wrote in a newsletter to members.

BRONX, New York—Essen Health Care, a New York-based medical services provider, announced it has been selected by the Centers for Medicare and Medicaid Services (CMS) to participate in the Guiding an Improved Dementia Experience (GUIDE) model, a new Medicare alternative payment model.

HOUSTON–Hospice providers and several state associations filed a lawsuit Thursday, Jan. 16, against the Department of Health and Human Services (HHS) to block the implementation of the Special Focus Program (SFP).

BALTIMORE—The Centers for Medicare and Medicaid Services (CMS) released its calendar year (CY) 2026 advance notice for the Medicare Advantage (MA) and the Medicare Part D prescription drug programs, which would update payment policies for these programs.

WASHINGTON—The Centers for Medicare and Medicaid Services (CMS) announced it is making additional resources and flexibilities available in response to the w

BALTIMORE—The Centers for Medicare and Medicaid Services (CMS) released the list of the 50 hospice companies selected for participation in the 2025 Hospice Special Focus Program (SFP). The SFP program, which will be led by the Center for Clinical Standards and Quality, aims to improve hospice quality through increased health and safety oversights.

MISSOULA, Montana—A Whitefish, Montana, doctor was sentenced to six months in prison, six months of home confinement and one year of supervised released after admitting to defrauding Medicare and other federal government health programs through a telemedicine conspiracy, which resulted in more than $31 million in false billing. Additionally, the doctor has been fined $100,000 and ordered to pay more than $780,509 in restitution. 

ATLANTA—Trella Health, a provider of market intelligence and integrated customer relationship management solutions, released a special edition report, which revealed declining access to home health agencies among Medicare fee-for-service (FFS) beneficiaries. 

The report investigated trends that shape home health accessibility, as well as how the expanding Medicare-eligible population often strains access to home health services. 

ARLINGTON, Virginia—The Centers for Medicare and Medicaid Services (CMS) released its consumer price index for all urban consumers (CPI-U) adjustment updates for calendar year (CY) 2025 durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fee schedules, the American Association for Homecare (AAHomecare) released in a recent newsletter to members.

WASHINGTON—A group of U.S. senators have written a letter expressing concern about “deep financial ties” the potential head of the Centers for Medicare and Medicaid Centers (CMS), Mehmet Oz, has with Medicare Advantage. The letter was written by multiple democratic senators, including Sen.

DALLAS—Axxess, a global technology platform for health care at home, announced its keynote speaker for its upcoming Axxess Growth, Innovation and Leadership Experience (AGILE) conference, as well as a new hospice outcomes and patient evaluation (HOPE) workshop and early bird pricing for AGILE 2025. The conference will be held Monday, May 5 through Wednesday, May 7, 2025, in Dallas, Texas.

WASHINGTON—The Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) released their fall 2024 semiannual report to congress (SAR), which found more than $7 billion in expected recoveries and receivables from misspent Medicare, Medicaid and other health and human services funds.

WASHINGTON—LeadingAge, an association of nonprofit providers of aging services, released a statement from its president and CEO, Katie Smith Sloan, regarding on the recently released Centers for Medicare and Medicaid Services (CMS) contract year (CY) 2026 Medicare Advantage (MA) and Part D proposed rule. The full statement by Sloan is detailed below.