All posts by Monica Arias

CMS Moratorium on New DME Businesses

By: Aaron R. Claxton

On February 27, 2026, the Centers for Medicare and Medicaid Services (“CMS”) issued a moratorium on the enrollment of new durable medical equipment (“DME”) suppliers with Medicare. The moratorium applies to the following seven supplier types:

  • Medical supply company
  • Medical supply company with orthotics personnel
  • Medical supply company with pedorthic personnel
  • Medical supply company with prosthetics personnel
  • Medical supply company with prosthetics and orthotics  personnel
  • Medical supply company with registered pharmacist
  • Medical supply company with respiratory therapist

In issuing the moratorium, CMS noted that their determination for the need to implement the moratorium was based on a high risk that fraud, waste, and abuse exists. CMS relied on historical Medicare enrollment and claims data and analyzed key metrics pertaining to enrollment volume and trends for more than eighty types of DME suppliers. Despite a relatively small number of bad actors, DME suppliers continue to be a prime target for allegations of fraud, waste, and abuse.

The moratorium will remain in effect for six months and may be extended thereafter. The CMS notice identifies the following changes that the moratorium does not apply to:

  • Changes in practice location (except if the location is changing from a location outside the           moratorium area to a location inside the moratorium area).
  •  Changes in provider or supplier information, such as phone number or address.
  •  Changes in ownership (except changes in ownership of home health agencies that would require an initial enrollment).

However, the moratorium would apply to suppliers that go through a change of ownership because a supplier that undergoes a nonexempt change in majority ownership within thirty-six months of its initial enrollment must enroll in Medicare as a brand new supplier, despite already operating prior to the moratorium. Additionally, changes of ownership that are the result of asset sales would also be impacted by the moratorium as the new owners would also have to enroll in Medicare as a new DME supplier. Applications submitted to CMS for new enrollment during the moratorium period will be denied and the applications will have to be resubmitted in the future once the moratorium is no longer in place.

The notice indicates that CMS believes the moratorium will not substantially limit Medicare beneficiaries’ access to care because “there is already an adequate nationwide quantity of such suppliers.” However, the number of overall suppliers does not take into account the fact that there may be limited numbers of specific types of suppliers and also fails to consider that there may already be very limited access to Medicare beneficiaries located in certain rural communities.

For existing DME suppliers, this moratorium serves as a barrier to entry to new suppliers that would compete with them for business. DME suppliers currently enrolled in Medicare should note the increased scrutiny that they face for allegations of fraud, waste, and abuse with the current administration. It is as important as ever for DME suppliers to prioritize regulatory and compliance efforts in order to maintain their Medicare enrollment and continue to serve the Medicare beneficiary population.

Aaron Claxton is a California healthcare attorney and partner with Wilke Fleury LLP focused on regulatory compliance for a range of clients providing healthcare services within the state.

A Cautionary Tale

By: Trevor L. Stapleton

We recently had a call from an individual, “Person X”, who was asked to pay money to a Companion to help settle the estate of the Companion’s father. Specifically, the money was necessary to pay estate taxes, to allow the release of the decedent’s assets. The Companion provided Person X a copy of a “Will” that seemed to look like a formal and “official” document. It had our firm’s name, logo, and address at the top, recited some “testamentary” sounding language, included the name of an attorney alleged to work at our firm, and had an official-looking “seal” near the signature line. The Companion indicated that several thousand dollars were needed to pay estate taxes, to allow for the release of the several million dollars in assets listed in the “Will.”  Thankfully, Person X was suspicious and, rather than just relying on an internet search to verify that our firm exists, Person X called us and sent us a copy of the “Will” to look at. There were numerous problems with the Companion’s story, and we could immediately see many issues with the document itself. In addition, to claim these assets, there would need to be a probate proceeding. Moreover, all the decedent’s money and property would be available and required to be used to pay any estate taxes, assuming any estate taxes would even be due, which is not necessarily the case due to current exemption amounts. So, a proper analysis required drawing together a number of elements that are not evident to someone without the requisite knowledge or experience in estate planning. Thankfully, Person X was suspicious and contacted us, and we were able to confirm that the story and the document were fake, and this was, unfortunately, a scam to take Person X’s money.

It was clear that the Companion had taken the time to piece together a document to support the tale and ask for money, and by including an actual law firm name, logo, and address, lend it credibility. Research on the internet would verify that yes, we are a law firm in Sacramento, and our services include estate planning, so it could be plausible that the document was authentic. But the internet cannot take the place of the knowledge, experience, and analysis of an estate planning professional.

So, please be careful, trust your instincts, and if something seems off, do not just rely on what you find online. Contact experienced professionals to assist you. A little time or cost now can save you and your family from heartbreak and disaster down the road.