Medicare's Remote Patient Monitoring Crackdown Meets Industry Pushback

The Medicare program has proposed changes to its remote patient monitoring (RPM) billing system, which would require vendors to be directly employed by healthcare providers. However, this proposal has met with opposition from UnitedHealth Group and CVS Health, among others.

UnitedHealth Group's insurance subsidiary, UnitedHealthcare, had previously attempted to stop paying for most RPM due to insufficient evidence of efficacy. The company now worries that the employment requirement could 'unintentionally restrict beneficiary access' to high-value vendors collaborating with clinicians.

CVS Health, which owns insurer Aetna, suggests instead establishing accountability standards for vendor use. It also proposes that billing providers remain in charge of all patient selection, treatment decisions, and oversight.

Some healthcare organizations argue that the ban on vendors would disproportionately impact integrated delivery systems and smaller practices relying on third-party contractors. They propose more focused approaches to RPM oversight, including capturing more information about who delivers care and closer monitoring of providers.