More than 200 healthcare organizations urged CMS not to finalize proposed limits on remote monitoring, warning the changes would disrupt care for about 1 million Medicare beneficiaries who manage chronic conditions from home.
In a sign-on letter to CMS Administrator Mehmet Oz, MD, the coalition asked the agency to hold off on remote physiologic monitoring and remote therapeutic monitoring policies included in the 2027 Medicare Physician Fee Schedule proposed rule. More than 30 health systems and hospitals signed the letter.
The provision at issue, proposed July 14, would allow clinical practices to bill Medicare for the services only if the clinical staff delivering them are directly employed by the billing practice rather than contracted through a third-party vendor. Staff could still work off-site; the billing relationship would have to run in-house.
That distinction carries broad reach. An estimated 60% to 70% of hospitals and health systems using remote monitoring rely on partially or fully outsourced vendor models, according to Becker’s prior reporting. The signers of the letter said small practices, rural providers and safety-net organizations would be hit hardest, and that many would have no option but to cut enrollment or end their programs.
CMS has tied the proposal to program integrity concerns, citing HHS Office of Inspector General findings that 43% of Medicare enrollees receiving RPM in 2022 missed at least one required service component. Medicare payments for the services rose 31%, from $408 million in 2023 to $536 million in 2024, as enrollment approached 1 million.
The coalition — which includes more than 30 health systems, among them Altamonte Springs, Fla.-based AdventHealth and St. Louis-based Ascension, along with 50 national patient and provider groups such as the American Telemedicine Association and the Federation of American Hospitals — said oversight concerns should be met with “proportionate, evidence-based guardrails” rather than broad access restrictions.
The letter argued the proposal cuts against the administration’s own push to expand technology-enabled care through the Rural Health Transformation Program.
“A policy intended to strengthen oversight should not increase costs to taxpayers,” the signers wrote, cautioning that restricting the services would send patients back to costlier emergency department visits and hospitalizations.
The public comment period on the proposed rule closes Sept. 14.
The hospitals and health systems that signed the letter:
- AdventHealth (Altamonte Springs, Fla.)
- Ascension Health (St. Louis)
- ChristianaCare (Wilmington, Del.)
- Community Health Systems (Franklin, Tenn.)
- Corewell Health (Grand Rapids and Southfield, Mich.)
- Duke University Health System (Durham, N.C.)
- Emory Healthcare (Atlanta)
- Essentia Health (Duluth, Minn.)
- Hackensack Meridian Health (Edison, N.J.)
- Harris Health System (Bellaire, Texas)
- Lakeland (Fla.) Regional Health Systems
- Lifebridge Health (Baltimore)
- MaineGeneral Health (Augusta, Maine)
- MedStar Health (Columbia, Md.)
- MemorialCare Health System (Fountain Valley, Calif.)
- Memorial Hermann Health System (Houston)
- Montefiore Health System (New York City)
- Prisma Health (Greenville, S.C.)
- Rush University System For Health (Chicago)
- Saint Francis Health System (Tulsa, Okla.)
- Sentara Health (Norfolk, Va.)
- Sharp HealthCare (San Diego)
- Stanford Health Care (Palo Alto, Calif.)
- Summit Health (New Providence, N.J.)
- Tampa (Fla.) General Hospital
- Texas Health Resources (Arlington)
- UnityPoint Health (West Des Moines, Iowa)
- University of Michigan Health (Ann Arbor)
- UVA Health (Charlottesville, Va.)
- Virginia Commonwealth University Health System (Richmond, Va.)
- Yale New Haven (Conn.) Health
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