Medicare DME suppliers face 90-day billing deadline and e-filing mandate starting 2027

What does this do?

HR 8871 requires suppliers of durable medical equipment to submit Medicare claims electronically beginning January 1, 2027, replacing paper filing. For most DME items, suppliers will have only 90 days after delivering equipment to submit a bill, down from up to a full calendar year. Items requiring a prior doctor visit, prior authorization, or billed on a monthly rental basis are exempt from the shorter deadline.

Who does it affect?

Companies and individuals who sell or rent durable medical equipment to Medicare patients are directly affected by both the electronic filing and shortened billing requirements. Medicare beneficiaries who depend on that equipment could be indirectly affected if suppliers have difficulty meeting the tighter deadlines.

Why does it matter?

The DME category has historically been a major target of Medicare fraud, and electronic claims are easier for Medicare systems to flag for suspicious patterns or double billing before payment is issued. The Government Accountability Office is required to report to Congress by 2030 on how effectively Medicare's screening technology is catching problematic claims under the new rules.

Where does it stand?