FAIR DME Appeals Act

The FAIR DME Appeals Act allows small business suppliers of durable medical equipment to recover legal fees and litigation costs if they win an appeal against a Medicare contractor's initial denial of payment. To qualify, the supplier must prove the denial was clearly erroneous or unsupported by evidence, and the bill excludes cases where the supplier failed to provide required documentation or comply with billing rules. When a supplier wins, the contractor that made the original denial must pay the fees, though the bill requires splitting the cost evenly if another contractor later affirmed the denial. The law also prevents Medicare contractors from using standard indemnification clauses to avoid paying these fees and mandates that suppliers return any awarded fees if the appeal was obtained through fraud or bad faith.