Health systems are not the only groups pushing back against a CMS proposal to restrict remote patient monitoring.
In July, CMS pitched banning Medicare payments for remote patient monitoring services carried out by third-party companies. As proposed, starting Jan. 1, 2027, payments for remote physiologic and therapeutic monitoring would be permitted only when furnished by clinical staff directly employed by the billing practice. CMS accepted comments on the proposed rule until Sept. 14.
On that date, UnitedHealth Group, CVS Health and Kaiser Permanente all voiced concerns in their respective letters to CMS.
Kaiser said it “strongly opposes” the pitch, “which would create substantial barriers to the delivery of [remote physiologic monitoring] and [remote therapeutic monitoring] services and have an outsized impact on integrated delivery systems.” Integrated systems, such as Kaiser, may leverage clinical staff across business units, and the proposal could challenge their ability to deliver these services. Kaiser recommended withdrawing the proposal.
While UnitedHealth agreed that not all vendors are delivering strong remote patient monitoring services, the company was concerned the proposal could limit access to “high-value vendors” who work closely with clinicians, possibly disrupting care models. UnitedHealth and CVS advocated for accountability standards for third parties.
“The billing practitioner should remain responsible for patient selection, the plan of care, clinical oversight, documentation and action on clinically significant findings,” CVS’ letter said. “CMS should monitor claims trends and use its authority to implement targeted claims edits, audits or pre-payment review where monitoring does not appear to be reasonable and necessary.”
CVS and Kaiser also addressed the potential of remote monitoring in rural and underserved areas.
More than 230 healthcare organizations, including 35 health systems, signed a coalition letter, as well. The letter said, under the proposed rule, care could be disrupted for roughly 1 million Medicare beneficiaries.
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