DME Scammer Prevention Act of 2026

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8871 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 8871

  To amend title XVIII of the Social Security Act to promote Medicare 
    program integrity with respect to certain medical equipment and 
                               supplies.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              May 19, 2026

 Mr. Bean of Florida introduced the following bill; which was referred 
    to the Committee on Energy and Commerce, and in addition to the 
Committee on Ways and Means, for a period to be subsequently determined 
 by the Speaker, in each case for consideration of such provisions as 
        fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL

 
  To amend title XVIII of the Social Security Act to promote Medicare 
    program integrity with respect to certain medical equipment and 
                               supplies.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``DME Scammer Prevention Act of 
2026''.

SEC. 2. PROMOTING MEDICARE PROGRAM INTEGRITY WITH RESPECT TO CERTAIN 
              MEDICAL EQUIPMENT AND SUPPLIES.

    (a) Electronic Submission of Claims by All Providers and 
Suppliers.--Section 1862(h) of the Social Security Act (42 U.S.C. 
1395y(h)) is amended--
            (1) in paragraph (1)(A)(ii), by striking ``the entity'' and 
        inserting ``except in the case of claims for specified items 
        (as defined in paragraph (3)), the entity''; and
            (2) by adding at the end the following new paragraph:
    ``(3) For purposes of paragraph (1)(A)(ii), the term `specified 
items' means medical equipment and supplies (as defined in section 
1834(j)(5)) furnished on or after January 1, 2027, that are included on 
the Master List described in section 1834(a)(23).''.
    (b) Submission of Claims Within 90 Days.--Section 1842(b)(3) of the 
Social Security Act (42 U.S.C. 1395u(b)(3)) is amended--
            (1) in subparagraph (B), in the flush matter following 
        clause (ii), by inserting ``(or, in the case of claims for 
        applicable items, the period ending 90 days after such date of 
        service)'' after ``date of service''; and
            (2) in the flush matter following subparagraph (L)--
                    (A) in the sixth sentence--
                            (i) by inserting ``or end of the 90-day 
                        period specified in such subparagraph (as 
                        applicable)'' after ``close of the following 
                        calendar year''; and
                            (ii) by inserting ``or end of such period 
                        (as applicable)'' after ``close of such year'';
                    (B) in the ninth sentence, by inserting ``or 90-day 
                period (as applicable)'' after ``1 calendar year 
                period''; and
                    (C) by adding at the end the following new 
                sentence: ``For purposes of subparagraph (B), the term 
                `applicable items' means specified items (as defined in 
                section 1862(h)(3)), other than any such item that is 
                included on the Required Face-to-Face Encounter and 
                Written Order Prior to Delivery List described in 
                section 410.38(c)(8) of title 42, Code of Federal 
                Regulations (or a successor regulation) or on the 
                Required Prior Authorization List described in section 
                414.234(c)(1) of title 42 of such Code (or a successor 
                regulation) or for which payment is made on a monthly 
                rental basis.''.
    (c) Report.--
            (1) In general.--Not later than January 1, 2030, the 
        Comptroller General of the United States shall submit to 
        Congress a report on the technology used by medicare 
        administrative contractors to screen claims for specified items 
        to identify errors or indicators of potential waste, fraud, or 
        abuse. Such report shall include, with respect to the 1-year 
        period beginning on January 1, 2027--
                    (A) an examination of--
                            (i) the total number of such claims 
                        submitted during such period for which payment 
                        was initially denied on the basis of such 
                        screening technology; and
                            (ii) the total number of claims so denied 
                        for which payment was ultimately made; and
                    (B) an examination of the extent to which the use 
                of such screening technology (taking into account the 
                amendments made by subsections (a) and (b)) assists in 
                the identification of--
                            (i) suspicious claims or aberrant billing 
                        practices that may be indicative of improper 
                        payments; and
                            (ii) the basis of claims denials.
            (2) Definitions.--In this subsection:
                    (A) Medicare administrative contractor.--The term 
                ``medicare administrative contractor'' has the meaning 
                given such term in section 1874A(a)(3) of the Social 
                Security Act (42 U.S.C. 1395kk-1(a)(3)).
                    (B) Specified items.--The term ``specified items'' 
                has the meaning given such term in section 1862(h)(3) 
                of the Social Security Act, as added by subsection (a).
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