FAIR DME Appeals Act

Sponsor: Bill Cassidy (Republican-LA)July 22, 2026

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Introduced

In Committee

Passed One Chamber

Passed Both Chambers

Signed into Law

Read twice and referred to the Committee on Finance.

Small medical equipment businesses could get legal fees paid if Medicare denies claims incorrectly.

This bill would help small businesses that supply medical equipment. If Medicare contractors wrongly deny their payment claims, these businesses could get their legal fees and costs paid back. This changes current rules. Currently, these businesses often pay legal fees themselves, even if they win an appeal.

What Would Change

Today, small businesses supplying medical equipment often pay their own legal fees even if they win an appeal against an incorrect Medicare payment denial. If this bill becomes law, these businesses would be able to recover those legal fees and costs from the Medicare contractors who made the incorrect denial. This would happen under specific conditions and after new regulations are put in place.

Key Provisions

Requires Medicare contractors to pay reasonable attorney fees and litigation costs for small medical equipment businesses that win certain appeals.
Sets rules for how contractors would split legal fees if more than one was involved in an incorrect denial.
Outlines a process for businesses to apply for these fees within 30 days of winning an appeal.
Gives administrative law judges 60 days to decide on fee amounts, and their decision cannot be appealed.
Prevents payment of fees if the business failed to provide required documents or follow billing rules, if the denial was based on rules that later changed, or if it was based on a local coverage determination (LCD) in effect at the time.

View on Congress.gov

S 5062 · 119th Congress · July 22, 2026 · AI Summary by gemini-2.5-flash · 8/10

FAIR DME Appeals Act

What Would Change

Key Provisions

Lobbying Activity