Enhancing Oversight of Remote Patient Monitoring in Medicare

In September 2024, the Department of Health and Human Services Office of Inspector General (OIG) published a report entitled Additional Oversight of Remote Patient Monitoring in Medicare is Needed. Remote patient monitoring (RPM) enables patients to collect their own health data, such as blood pressure, using a connected medical device that automatically transmits the information to their healthcare provider. The healthcare provider then uses this data to manage or treat the patient’s condition.

The OIG found that from 2019 to 2022, the provision of RPM services to Medicare enrollees significantly increased. However, the report noted that approximately 43% of Medicare enrollees receiving RPM services did not receive all required components of the service, raising concerns about whether RPM is being used as intended. Both the OIG and the Centers for Medicare & Medicaid Services (CMS) have expressed concerns about potential fraud associated with RPM. Additionally, the OIG expressed that CMS lacks critical oversight information, such as details about the providers who order RPM for Medicare enrollees.

To address these issues, the OIG recommends that CMS take several steps to enhance RPM oversight, including: implement safeguards to ensure the proper use and billing of RPM services; require RPM to be ordered by a provider and require that the provider’s information be included in claims and encounter data; develop methods to track the health data being monitored and provide education for providers on proper RPM billing practices; and identify and monitor companies billing for RPM services.

Click Here to read the entire October 2024 Healthcare Law Update now!