Practice Areas

Durable Medical Equipment Fraud

Durable medical equipment fraud occurs when suppliers bill Medicare or Medicaid for equipment that was not medically necessary, never delivered, or obtained through kickback arrangements. If you work in a DME company, a healthcare organization that prescribes or orders durable medical equipment, or in the supply chain for these products, and have witnessed any of these practices, you may have a viable qui tam case. Reach out for a confidential conversation. There is no obligation.

Practice Areas

Durable Medical Equipment (DME) Fraud

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WHAT IS DURABLE MEDICAL EQUIPMENT FRAUD?

Durable medical equipment includes items such as wheelchairs, walkers, orthotic braces, hospital beds, oxygen equipment, and nebulizers that Medicare and Medicaid cover for patients who have a documented medical need. To receive reimbursement, a supplier must have a valid physician order, the equipment must be medically necessary, and the equipment must actually be provided to the patient.

DME fraud occurs when suppliers bill Medicare or Medicaid for equipment that was not medically necessary, that the patient never received, or that was ordered through arrangements that involve illegal kickbacks to physicians or marketers. Because these claims are submitted to federal healthcare programs, they fall within the scope of the False Claims Act. Healthcare insiders who have direct, first-hand knowledge of DME fraud may be eligible to file a qui tam lawsuit on behalf of the government and receive a share of any financial recovery.

In March 2026, the owner of three durable medical equipment companies was sentenced to 90 months in prison for his role in a $59.9 million conspiracy to pay kickbacks and submit claims to Medicare for medically unnecessary DME, including orthotic braces such as knee, back, shoulder, and wrist braces.

Source: U.S. Department of Justice, March 9, 2026 | justice.gov

Legal basis: 31 U.S.C. § 3729 (False Claims Act) | 42 U.S.C. § 1395 et seq. (Medicare) | Source: uscode.house.gov

TYPES OF DME FRAUD THIS PRACTICE HANDLES

DME fraud encompasses a range of schemes. The following are the most common types handled by this practice.

Wheelchairs: Billing Medicare for power wheelchairs or other mobility equipment for patients who do not meet the medical necessity criteria, who were never assessed by a qualified therapist, or whose physician order was obtained through a kickback arrangement or telemedicine scheme rather than a legitimate clinical evaluation. Power wheelchair fraud has been a significant and sustained enforcement priority for the Department of Justice and HHS Office of Inspector General.

Orthotics: Billing Medicare for orthotic braces, including knee, back, shoulder, wrist, and ankle braces, for patients who did not need them, who were solicited by telemarketers rather than referred by their treating physician, or whose physician orders were signed without a legitimate physician-patient relationship. Orthotic brace fraud frequently involves telemarketing companies that generate large volumes of orders and DME suppliers that bill Medicare without verifying medical necessity.

Oxygen Equipment: Billing Medicare for home oxygen equipment for patients who do not meet the oxygen qualification criteria, or continuing to bill for oxygen equipment after the patient no longer qualifies or has returned the equipment. Oxygen equipment fraud may also include billing for higher-tier equipment than was actually provided, or misrepresenting the patient’s oxygen saturation levels to meet the coverage threshold.

Unnecessary Equipment Billing: Billing Medicare or Medicaid for any durable medical equipment that was not medically necessary, was never delivered to the patient, or was billed at a higher quantity or reimbursement level than what was actually provided. This includes billing for equipment under incorrect codes to obtain a higher reimbursement than the equipment qualifies for, and billing for new equipment when refurbished equipment was provided.

Legal basis: 31 U.S.C. § 3729(a)(1)(A) and § 3729(a)(1)(B) (False Claims Act) | 42 U.S.C. § 1395 et seq. (Medicare) | 42 U.S.C. § 1320a-7b (Anti-Kickback Statute) | Source: uscode.house.gov

WHO CAN REPORT DME FRAUD?

The strongest DME fraud qui tam cases come from current or former employees who have direct, first-hand knowledge of the fraudulent conduct from inside the organization. This includes billing and delivery staff who know what equipment was actually ordered and delivered, sales and marketing staff who are aware of telemarketing practices used to generate orders for patients who did not request the equipment, compliance and operations employees who have identified ordering or billing practices that do not reflect legitimate medical need, warehouse and logistics staff who know when equipment billed to Medicare was never shipped, and physicians or clinical staff who have been contacted to sign orders for patients they have never seen or examined.

You do not need all the documentation before contacting us. If you have credible, first-hand knowledge of what you believe constitutes false claims to Medicare or Medicaid in connection with durable medical equipment, that is enough to start a confidential conversation. We investigate thoroughly before asking for any commitment.

In fact, many former employees come forward with knowledge of fraudulent practices by their former employers after they have been demoted or terminated for complaining to their supervisors about the fraudulent practices or leaving their employment because they refuse to participate in the fraud.

Legal basis: 31 U.S.C. § 3730(b) (qui tam provisions) | Source: uscode.house.gov

YOUR PROTECTIONS AS A WHISTLEBLOWER

When you file a qui tam complaint, it is submitted under seal and served on the Department of Justice and any state agencies that have been impacted by the alleged fraud. During the time the case is under seal, your employer is not notified and does not receive a copy of the complaint. Your identity remains protected throughout the government’s investigation.

The False Claims Act prohibits your employer from firing, demoting, suspending, harassing, or otherwise retaliating against you for reporting fraud or participating in a qui tam case. These anti-retaliation protections apply to both current and former employees.

If your employer retaliates against you, you have legal remedies that include reinstatement, two times the amount of back pay owed, interest on that back pay, and compensation for special damages including litigation costs and attorney fees.

Legal basis: 31 U.S.C. § 3730(h) (anti-retaliation) | 31 U.S.C. § 3730(b) (under seal filing) | Source: uscode.house.gov

WHISTLEBLOWER REWARDS

When a qui tam lawsuit results in a financial recovery, the False Claims Act entitles the relator to receive a percentage of the total amount recovered by the government. If the government intervenes and takes over the case, the relator may receive between 15% and 25% of the recovery. If the government declines to intervene and the relator proceeds independently, the share can rise to between 25% and 30%. There is no cap on the dollar amount of the reward. We work on a contingency fee basis. There is no upfront cost, and if there is no recovery, you owe us nothing.

Legal basis: 31 U.S.C. § 3730(d)(1) and § 3730(d)(2) | Source: uscode.house.gov

About This Practice

Arvind Bob Khurana has over 27 years of experience in qui tam and False Claims Act litigation, complex commercial litigation, and class action matters. He began his career at a top international defense firm and joined a national class action firm in 2005, becoming partner in 2009, where he worked on ERISA actions, qui tam cases, securities fraud, and antitrust matters. He is admitted to the New York State Bar and represents whistleblowers in federal courts nationwide.

We are selective. Before we ask for any commitment, we investigate the claim, explain the facts and the risks, and give you a complete picture of what you are facing. We never ask you to sign a retainer agreement until you have the full picture and have decided, on your own terms, that you want to move forward. You remain in control throughout.

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Arvind Bob Khurana has over 27 years of experience in complex litigation. We work on contingency. There is no upfront cost and no obligation to proceed.