FAIR DME Appeals Act
The source supplies the latest action, but no lifecycle stage.
Latest action (22 Jul 2026): Read twice and referred to the Committee on Finance.
What this bill does
The FAIR DME Appeals Act would amend Medicare law to require certain Medicare contractors—Medicare administrative contractors, unified program integrity contractors, and qualified independent contractors—to pay the reasonable attorney fees and litigation costs of durable medical equipment (DME) suppliers when those suppliers win a final appeal before an administrative law judge and the judge finds the original coverage denial was clearly erroneous, unsupported by evidence, or contrary to applicable law or guidance. The bill sets procedures for suppliers to apply for these fees, allows contractors to respond, and directs judges to decide fee amounts using a standard "lodestar" calculation. Fees would not be owed if the denial resulted from the supplier's own paperwork or billing failures, or from a contractor correctly following law, guidance, or local coverage rules in effect at the time. Fees could be clawed back if a favorable decision is later found to have resulted from fraud or bad faith.
The bill primarily affects small-business DME suppliers who are incorrectly denied Medicare payment and must appeal, as well as the contractors responsible for making or reviewing those payment determinations, who would bear new financial liability for legal costs in qualifying cases. It also removes existing legal protections that currently shield some of these contractors from such liability and blocks the Secretary of Health and Human Services from indemnifying contractors for these specific costs.
The bill was introduced by Senator Bill Cassidy on July 22, 2026, and referred to the Senate Finance Committee. It has not yet been voted on. If enacted, the Secretary would have two years to issue implementing regulations, and the changes would apply to contracts entered into starting the following January.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Timeline
22 Jul 2026
Read twice and referred to the Committee on Finance.
Common questions
- What does S. 5062 do?
- The FAIR DME Appeals Act would amend Medicare law to require certain Medicare contractors—Medicare administrative contractors, unified program integrity contractors, and qualified independent contractors—to pay the reasonable attorney fees and litigation costs of durable medical equipment (DME) suppliers when those suppliers win a final appeal before an administrative law judge and the judge finds the original coverage denial was clearly erroneous, unsupported by evidence, or contrary to applicable law or guidance. The bill sets procedures for suppliers to apply for these fees, allows contractors to respond, and directs judges to decide fee amounts using a standard "lodestar" calculation. Fees would not be owed if the denial resulted from the supplier's own paperwork or billing failures, or from a contractor correctly following law, guidance, or local coverage rules in effect at the time. Fees could be clawed back if a favorable decision is later found to have resulted from fraud or bad faith. The bill primarily affects small-business DME suppliers who are incorrectly denied Medicare payment and must appeal, as well as the contractors responsible for making or reviewing those payment determinations, who would bear new financial liability for legal costs in qualifying cases. It also removes existing legal protections that currently shield some of these contractors from such liability and blocks the Secretary of Health and Human Services from indemnifying contractors for these specific costs. The bill was introduced by Senator Bill Cassidy on July 22, 2026, and referred to the Senate Finance Committee. It has not yet been voted on. If enacted, the Secretary would have two years to issue implementing regulations, and the changes would apply to contracts entered into starting the following January.
- Has S. 5062 become law?
- The source does not supply a confirmed lifecycle stage for S. 5062. Check the latest action and official source below.
- Who sponsored S. 5062?
- S. 5062 was sponsored by Sen. Cassidy, Bill [R-LA] (R-LA), with 0 cosponsors.
- What's the latest action on S. 5062?
- Read twice and referred to the Committee on Finance. (22 Jul 2026).
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