CMS froze new O&P supplier enrollment in February to fight fraud. The six-month clock is almost up.

The Centers for Medicare & Medicaid Services put a hold on new DMEPOS enrollment effective February 27, citing fraud and abuse concerns in the supplier system. The moratorium was announced with a planned six-month life, which puts the expiration somewhere in the final days of August. The O&P EDGE reported this week on compliance risks that have been accumulating for O&P providers caught inside that window.

This is a good moment to explain what the freeze actually did—and what it did not do—for the people on the receiving end of O&P care.

What an enrollment moratorium is

DMEPOS is the Medicare category that covers durable medical equipment, prosthetics, orthotics, and supplies. A CMS enrollment moratorium does not stop enrolled suppliers from billing or from treating patients. What it stops is the front door: new applications to become a Medicare DMEPOS supplier are not processed during the freeze, and existing enrolled providers who need to re-enroll—because their enrollment lapsed, or they are adding a new location, or they changed business structure—run into a closed window.

The reason CMS reaches for this tool is that DMEPOS enrollment fraud is a documented and recurring problem. Bad actors enroll, bill for equipment or services that were never provided, and then vanish. A moratorium slows that entry point while enforcement actions work through the existing supplier base.

The compliance bind for providers

The compliance risks flagged by The O&P EDGE land on the provider side, not the patient side. O&P practices that have encountered an enrollment irregularity during the moratorium window cannot simply re-enroll to resolve it. A solo practitioner who changes practice addresses, a clinic expanding into a new state, or a provider whose enrollment paperwork has a documentation gap all face the same wall: CMS is not processing new DMEPOS applications in the affected categories, so problems that would ordinarily be corrected through re-enrollment have no near-term fix.

For the practices that serve amputees and limb-different people, that is a compliance cloud that has been sitting over operations for six months.

What patients have actually felt

If you are a Medicare beneficiary and your current prosthetist or orthotist was already enrolled before February 27, the moratorium has most likely not affected your appointments, your claims, or your coverage. Enrolled providers kept their billing rights.

The indirect effects are harder to see and harder to measure. The pool of new Medicare-participating O&P providers has not grown during the freeze. If a clinic closed, a solo practitioner retired, or a new practice opened in your area but cannot yet bill Medicare, the in-network options are thinner than they would have been without the moratorium. In geographic areas that were already underserved, that math is worse.

Finding a new Medicare-enrolled O&P provider is something patients can check directly. CMS maintains a DMEPOS supplier directory through Medicare’s Care Compare tool at medicare.gov. “Enrolled” status is public information.

What happens when the clock runs out

The moratorium is scheduled to expire in late August. What CMS does next matters: it can let the moratorium lapse on schedule, extend it, or narrow its scope. As of publication there has been no public announcement of an extension—that situation can change.

When the moratorium does lift, providers who have been blocked from enrolling or re-enrolling can start applications again. Processing an enrollment application takes time on its own. A cleared moratorium does not mean an immediate return to a full supplier network. The backlog clears at the pace of CMS processing, which is not fast.

The desk will be watching whether the expiration produces a public status update from CMS, and whether the compliance situations flagged by the O&P provider community move toward resolution.

Questions worth asking

If you are looking for a new O&P provider through Medicare, or your current clinic has recently changed its billing arrangements:

• Is this practice currently enrolled as a Medicare DMEPOS supplier?
• If enrollment is pending, what is your expected timeline and is there another enrolled provider who can cover my care?
• Has anything changed in how my claims are being submitted?

If you have received a bill you believe Medicare should have covered, the starting point is your provider’s billing office and, if needed, Medicare directly at 1-800-MEDICARE. A State Health Insurance Assistance Program (SHIP) counselor can help navigate a complicated situation at no cost.

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Amputee News does not provide individualized insurance, coverage, or enrollment advice. Medicare DMEPOS coverage depends on a person’s diagnosis, functional assessment, documentation, and specific item classification. For questions about your coverage or a claim, contact your O&P provider, your Medicare plan, or a patient advocate.