Bill · S. 5062· Senate(119-S-5062)
FAIR DME Appeals Act
- Introduced
- 7/22/2026
- Last activity
- 7/22/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Bill Cassidy
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
This bill, known as the "FAIR DME Appeals Act," aims to amend the Social Security Act regarding Medicare payments. It requires certain contractors—specifically medicare administrative contractors, unified program integrity contractors, and qualified independent contractors—to pay legal fees and litigation costs to certain durable medical equipment suppliers. This requirement applies when a small business supplier wins a favorable final appeal after an initial determination was found to be clearly erroneous, not supported by substantial evidence, or in violation of law. The bill outlines a process for submitting fee applications to an administrative law judge and establishes rules for splitting these costs among multiple contractors. It also includes specific exceptions where these payments would not be required.
Yes
Would business owners be better off under this?+7
The bill specifically benefits small business owners in the DME industry by providing a mechanism to recover legal costs from erroneous administrative decisions.
Does this make it easier to run a small business?+6
The bill provides financial relief to small business DME suppliers by requiring contractors to pay their legal fees in cases of erroneous denials.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Financial Relief for Small Businesses: Small business suppliers of durable medical equipment can have their reasonable attorney fees and litigation costs paid by covered contractors if they win a favorable final appeal due to an erroneous initial determination. (Section 2(a)(1)(A))
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Accountability for Errors: The bill ensures that if an administrative law judge determines an initial determination was clearly erroneous, not supported by substantial evidence, or failed to follow applicable laws or regulations, the contractor responsible must cover the legal costs. (Section 2(a)(1)(A))
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Fairness in Legal Costs: Suppliers can recover costs for every stage of the appeal process, including stages where they did not receive a favorable decision. (Section 2(a)(1)(A)(i-ii))
Potential Negative Impacts for People
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Financial Burden on Contractors: Covered contractors (medicare administrative contractors, unified program integrity contractors, and qualified independent contractors) will be required to pay reasonable attorney fees and litigation costs for suppliers who win appeals under the specified conditions. (Section s 2(a)(1)(A))
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Cost Splitting Liability: If multiple contractors are involved in affirming an initial determination, they must split the reasonable attorney fees and litigation costs evenly. (Section 2(a)(1)(B))
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Restrictions on Reimbursement: The Secretary is prohibited from providing indemnification for these legal fees and costs. (Section 2(b)(1)(A))
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Business Owners+7
- Economy And Finance
- Improves Small Business Support+6
- 7/22/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate