[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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