What changes are proposed for Remote Patient Monitoring (RPM) under the CY 2027 Medicare Physician Fee Schedule?

CMS has proposed to allow Medicare reimbursement for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) only when furnished by clinical staff directly employed by the billing practice, restricting the use of third-party contractors for clinical monitoring services.

How does New Jersey P.L.2026, c.40 change telemedicine prescribing for Schedule II controlled substances?

P.L.2026, c.40 expands exemptions from in-person requirements for minors prescribed stimulants by removing two-way audio-video mandates (with written parental consent), adds exemptions for cancer, hospice, and long-term care patients, and allows initial telehealth visits for adults prescribed Schedule II stimulants if an in-person visit occurs within 30 days.

What is the federal Patients First Act (H.R. 9693)?

Introduced by the chairs of the Doctors Caucuses, H.R. 9693 proposes to reform MACRA by tying annual physician payment updates to the Medicare Economic Index (MEI), launching a 5-year primary care hybrid payment pilot, and replacing MIPS with the clinician-developed POINTS system.

Healthcare Law Update – September 2026

On July 9, 2026, the U.S. Attorney’s Office for the District of New Jersey announced criminal charges against six individuals in connection with an alleged healthcare fraud and kickback scheme. According to the indictment, the defendants defrauded Medicare and Medicaid by, among other things, issuing medically unnecessary prescriptions in exchange for cash kickbacks. The defendants allegedly caused approximately $20.7 million in losses to Medicare and Medicaid.

According to the indictment, a pharmacy owner referred patients and paid illegal kickbacks to a physician in exchange for the physician issuing

On May 14, 2026, the New Jersey Office of the State Comptroller (OSC) released an audit report of Bonnie Brae, a Medicaid provider of residential treatment services for youths. The audit identified significant deficiencies in documentation and compliance with Medicaid and Department of Children and Families requirements, and recommended that Bonnie Brae repay $1,528,109 in Medicaid reimbursements.

Key findings in the audit report included:

• Service hours did not reconcile with employee timesheets, implying that staff furnished more hours of services than reflected in their timesheets.
• Individual therapy sessions that overlapped, which could not have occurred as documented.

• Nearly identical progress notes used for multiple patients and sessions, implying that care was not individualized.
• Documentation of services rendered to youth when other records indicated they were absent.
• Lack of documentation of required clinical, psychiatric, and case management services.
• Two clinical coordinators provided services while unlicensed.

The OSC recommended strengthened documentation and internal controls, verification of staff licensure, repayment of the identified overpayment, and independent monitoring. In response, Bonnie Brae submitted a corrective action plan addressing the OSC’s recommendations; however, Bonnie Brae did not address repayment of the overpayment. The audit highlights the importance of accurate, contemporaneous documentation, and effective compliance controls for Medicaid providers.

On July 15, 2026, Reps. Kim Schrier (D-WA), John Joyce (R-PA), and Greg Murphy (R-NC), the chairs of the Democratic and Republican Doctors Caucuses, introduced the bipartisan Patients First Act (H.R. 9693), comprehensive legislation that would reform the Medicare Access and CHIP Reauthorization Act (MACRA) and address ongoing concerns regarding Medicare physician reimbursement. Among other provisions, the bill would tie annual physician payment updates to the Medicare Economic Index (MEI), subject to certain guardrails; establish a five-year primary care hybrid payment pilot program that would provide participating independent primary care physicians with per-member,

per-month payments in addition to fee-for-service payments; and replace the Merit-Based Incentive Payment System (MIPS) with the Patient Outcome Improvement National Tabulation System (POINTS), which would use physician and clinician developed quality measures intended to reduce administrative burden. The legislation would also increase the Medicare Physician Fee Schedule budget neutrality threshold from $20 million to approximately $54.3 million, and make other changes intended to promote independent physician practices and reduce payment volatility.

The proposed legislation comes as physician practices continue to face pressure from rising costs and Medicare payment updates that have not kept pace with inflation. The Centers for Medicare & Medicaid Services’ CY 2027 Medicare Physician Fee Schedule, released one day before the bill was

On July 16, 2026, the Centers for Medicare & Medicaid Services (CMS) published the CY 2027 Medicare Physician Fee Schedule Proposed Rule, which includes significant proposed changes to Medicare payment policies for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM). Most notably, CMS has proposed to permit payment for RPM and RTM services only when the services are furnished by clinical staff employed by the billing practice, but not when the services are furnished by contractors. CMS

has also proposed to require a separately reportable initiating visit in connection with the start of RPM or RTM services and, for RTM, to limit the service to established patients. If finalized, these changes could significantly affect physician practices that currently rely on third-party companies to furnish clinical monitoring services, although practices could continue to use outside vendors for technology and other non-clinical functions.

According to CMS, the proposed changes are intended, in part, to address program integrity concerns identified in recent Office of Inspector General (OIG) reports regarding RPM. Among other findings, the OIG reported that approximately 43% of Medicare beneficiaries receiving RPM did not receive all three required components of the service, which include patient education and device setup, device supply, and treatment management. CMS also expressed concerns regarding the marketing and enrollment practices of certain companies providing remote monitoring services. Comments on the proposed rule are due by September 14, 2026.

that the provider use two-way audio and video during the encounter, while retaining the requirement for written parental consent. The revised law also creates new exemptions from in-person requirements for patients in active cancer treatment, receiving hospice or palliative care, residing in long-term care facilities, or receiving treatment for a substance use disorder. For adult patients prescribed Schedule II stimulants, the revised law permits the initial examination to be conducted via telemedicine, provided an in-person visit

A class action lawsuit was filed in a Colorado federal district court on August 5, 2026 against the University of Colorado Health (UCH) alleging UCH’s “intentional interception and disclosure of Plaintiff’s and Class Members’ confidential personally identifiable information and protected health information through [UCH’s] implementation and use of the Meta/Facebook tracking pixel on its website, including Defendant’s ‘Find a Doctor’ tool” and patient portal, in violation of HIPAA and the federal Electronic Communications Privacy Act.

The plaintiff in the action is a patient of UHC and filed the lawsuit on his own behalf and on behalf of other similarly situated individuals. In the Complaint filed in the action, the plaintiff alleged that UHC’s Find a Doctor Tool website was configured by UHC to cause the contents of communication made by website users (including patients and prospective patients) to be contemporaneously duplicated and transmitted to

Meta/Facebook, together with identifying information such as IP addresses, device identifiers, browser identifiers, cookie identifiers, and/or Facebook-linked identifiers. The plaintiff further alleged that UHC configured the Meta/Facebook tracking pixel and/or similar technologies on its patient portal.

In light of this lawsuit and others like it, HIPAA covered entities and their business associates should take heed. Website, patient portal pages, and configurations should be carefully reviewed to ensure that tracking technologies are not being implemented in a manner that would result in impermissible disclosures of protected health information, for example, to tracking technology vendors for marketing purposes without individual authorizations. The Department of Health & Human Services has issued guidance on this topic, as modified by an order issued by the U.S. District Court for the Northern District of Texas, as described in the guidance.

Shannon Carroll | 973.403.3126 | scarroll@bracheichler.com
Riza I. Dagli | 973.403.3103 | rdagli@bracheichler.com
Lani M. Dornfeld, CHPC | 973.403.3136 | ldornfeld@bracheichler.com
John D. Fanburg, Chair | 973.403.3107 | jfanburg@bracheichler.com
Joseph M. Gorrell | 973.403.3112 | jgorrell@bracheichler.com
Carol Grelecki | 973.403.3140 | cgrelecki@bracheichler.com
Edward Hilzenrath, HLU Editor | 973.403.3114 | ehilzenrath@bracheichler.com
Caroline J. Patterson, Vice Chair | 973.364.5233 | cpatterson@bracheichler.com
Keith J. Roberts | 973.364.5201 | kroberts@bracheichler.com
Richard B. Robins | 973.447.9663 | rrobins@bracheichler.com
Jonathan J. Walzman | 973.403.3120 | jwalzman@bracheichler.com
Edward J. Yun | 973.364.5229 | eyun@bracheichler.com