Healthcare leaders urge caution in fraud enforcement

Healthcare leaders urge caution in fraud enforcement

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As healthcare affordability continues to persist as a top concern for voters ahead of the 2026 midterm elections, the Trump administration has pursued Medicare and Medicaid fraud across the country.

In February, President Donald Trump announced the White House Fraud Task Force, a group led by Vice President JD Vance to pursue fraud schemes across the government. Since then, the task force has pursued dozens of criminal indictments, advanced a six-month moratorium on durable medical equipment and deferred billions in Medicaid to certain states including California.

Ryan Bullock, chief strategy officer at Aeroflow Health, said he is concerned about the moratorium on durable medical equipment. Aeroflow Health is a provider of durable medical equipment, including breast pumps, CPAP machines and diabetes supplies.

“The part that concerns us is either taking a scalpel and being really purposeful in slicing up and identifying fraud versus [using] blunt instrument[s] and taking a broad brush approach,” Bullock told The Center Square.

The six-month moratorium is set to expire in August. Bullock said he hopes the administration will come out of that period with goals to deter future fraud.

“What we’re hopeful to see, and we’ve not heard anything yet, is that the moratorium is lifted, and there’s better controls on the front end with new suppliers that are allowed to enter into the DME supplier category,” Bullock said.

Advocates and federal prosecutors have warned about fraud schemes with money used for durable medical equipment. In July 2025, the U.S. Department of Justice charged a Florida man for conspiring to defraud Medicare with false reimbursement claims for durable medical equipment. He was sentenced to 12 years in prison and ordered to pay more than $21 million in restitution.

“This unfortunate necessity is going to allow us to get on top of what we believe is billions of dollars of [durable medical equipment] frauds,” Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said. “We already stopped a billion and a half dollars of billing, but we need more time to shut down these bad guys.”

While the moratorium has continued over the past several months, Aeroflow Health’s business has slowed down. A new location in Tampa, Florida, that Aeroflow planned is awaiting to submit its application for a Medicare supplier number.

“We have multiple audits that we’ve been through with Medicare. We pass those audits,” Bullock said. “I think we’ve proven that we are good stewards of the taxpayer dollars and the Medicare trust fund in supporting the Medicare beneficiaries for the products and services that we provide.”

The Trump administration sought comments from industry leaders in the healthcare and durable medical equipment industries. Aeroflow Health submitted comments suggesting recommendations for the program as the moratorium is set to end.

Bullock said the moratorium needs to end in order for a proper system to take its place.

“If the blanket pause continues to be renewed, it’s not a fraud prevention success, but rather an admission the vetting process is still not built,” Bullock said.

He also called on the administration to update its random sampling period of Medicare recipients. Bullock said the current system to evaluate fraud does not assess when to cut off federal funds in a timely manner.

“A new method using artificial intelligence to find abnormalities in data, which can then be presented to enforcement agencies and contractors for further research,” Bullock said.

He also called on the administration to open up more lines of communication with business leaders and the public about the success rate of its fraud enforcement efforts. He said government officials should share how they go about launching formal investigations based on tips and what percentage of those turn into fraud indictments or convictions.

He said this also includes transparency for investigations that do not lead toward the desired fraud prevention results.

“If we’re still suspending 5 or 6 billion dollars a year in 2029, we didn’t prevent fraud, we just got more efficient at chasing it,” Bullock said. “The goal of a detect-and-prevent model is for criminals to stop getting in the front door, which means fewer suspensions, fewer referrals, and a shrinking improper payment rate.”

As the Trump administration and other congressional Republicans make fraud central to their political campaigns, Bullock said he and other leaders in the healthcare space are urging for cautious policy that stops bad actors and protects other providers.

“We have an opportunity to focus around providing what we think good policy looks like, providing public comment when those opportunities arise to what we think good guardrails should be to allow us to run and operate our business in the DME space,” Bullock said.

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