Medicare patients may soon lose access to remote monitoring devices

Dianne Williams said her health improved after she started combining quarterly doctor visits, monthly phone calls with a nurse, and a blood pressure cuff she uses at home to send readings to her care team.

“It’s good to have somebody talk to you and tell you what your progress is like. And she’s a very nice person,” Williams said about her nurse.

Living in rural Georgia, Williams said remote patient monitoring helped her stay on her medication and motivated her to change her diet and exercise routine.

Still, many Medicare patients — especially those in rural communities like hers — could soon lose the ability to use these devices and get coaching from home.

A proposed federal rule would stop Medicare from reimbursing providers who rely on health technology companies to run remote monitoring programs. Under the proposal, Medicare would pay clinicians only when the service is delivered by someone at the facility where they work.

The Centers for Medicare & Medicaid Services said the proposal responds to reports from the Department of Health and Human Services’ Office of Inspector General, an independent federal watchdog. Recent reports raised concerns about fraud, weak data collection, and patients not being treated by the clinician who prescribed the device.

Caroline Pearson, executive director of the nonprofit Peterson Center on Healthcare, said the change would “virtually eliminate the use of remote monitoring services, or dramatically reduce the use,” for many Medicare patients.

“I think the rural communities will be some of the hardest hit,” said Pearson, whose organization focuses on healthcare affordability.

She said remote monitoring can be especially valuable in rural areas, where patients may struggle to get to in-person appointments. Most rural facilities that offer these programs depend on third-party vendors because they do not have the staff or resources to build and manage the programs themselves, she said.

CMS spokesperson Timothy Foster said the agency “recognizes the important role that technology-enabled care can play in improving access to care, including in rural communities.” But he said additional safeguards are needed.

The proposed rule says outside vendors may have “little to no established relationship” with patients and their clinicians, which it argues can “fragment care.” It also says some clinicians may not be involved enough to justify Medicare payment. Pearson, other health policy experts, and vendors agree that the programs need more oversight, but public comments show broad opposition to CMS’ approach.

“The proposal took us by such surprise,” said Andrew Van Ostrand, senior vice president at the Alliance for Connected Care, a group that promotes wider use of health technology, including remote monitoring, on behalf of healthcare organizations and tech companies.

Van Ostrand said many vendors have already made changes based on the “very well-reasoned recommendations” from HHS’ Office of Inspector General and were surprised that the proposed Medicare rule did not require all of those suggestions.

The proposal would apply only to people enrolled in traditional Medicare, not to those in privately run Medicare Advantage plans, which cover more than half of Medicare participants. But Van Ostrand and Pearson said Medicare Advantage plans, Medicaid programs, and private insurers could still follow the same path, further reducing access.

Van Ostrand said the vendor rule and other proposed changes — including a “draconian” reimbursement cut — are in “deep misalignment” with one of President Donald Trump’s signature efforts: the five-year, $50 billion Rural Health Transformation Program, which encourages states to adopt technology to improve rural care.

States have set aside at least $240 million from their first-year rural health funding for remote monitoring, according to an Alliance for Connected Care report. The group also wrote to CMS to oppose the change.

More than 230 health tech vendors, healthcare systems, and patient and medical advocacy groups had signed the opposition letter as of Sept. 14.

A handful of organizations support the proposal, including Humana, the Blue Cross Blue Shield Association, and Sutter Health, a large health system that runs its own remote monitoring program.

Remote patient monitoring 101

Remote monitoring can be used for patients in physical therapy, recovering from surgery or hospitalization, or living with chronic illnesses such as diabetes or heart disease.

The goal is to help people manage their conditions and avoid dangerous complications or costly emergency room visits. It can also make care easier to access for patients who have trouble traveling to appointments — including people with disabilities, those without cars, and people in rural areas far from hospitals.

To track her blood pressure, Williams straps a cuff to her arm and presses a button. The device automatically sends her readings to CoachCare, a private company whose staff monitor patients.

“I don’t have to wait until I go to the doctor’s office when I can do it every day,” Williams said.

Other patients may use scales, blood glucose monitors, and fitness bands that send data reviewed by nurses or other staff members, increasingly with assistance from artificial intelligence.

Some large academic health systems build their own devices or use their own employees to review the data and check in with patients. But most healthcare facilities contract with health tech companies.

If staff notice — or AI flags — data trending in the wrong direction, they can call patients, offer advice, or set up a follow-up visit with a doctor. If vital signs point to a life-threatening emergency, staff tell patients to call 911.

Williams said she grew frustrated when her medication did not lower her blood pressure. She said her CoachCare nurse then advised her to exercise and eat more healthfully.

“That made me feel better, because they gave me encouragement,” she said. “They just didn’t just take my blood pressure and that was it.”

Williams said she now walks at a local track every day and has changed her diet, including switching from fried fish to baked fish.

Edward Vance, chief medical officer of Albany Area Primary Health Care, which includes Williams’ clinic, said the health system — which serves many rural and low-income patients — could not provide remote monitoring without an outside vendor.

“We already run at a borderline understaffed situation,” he said, and many community health centers operate on “shoestring budgets.”

Growing pains

The federal government created Medicare billing codes for remote patient monitoring during Trump’s first presidency. That allowed providers to be reimbursed for starting and overseeing these services, and health facilities often use part of that money to pay vendors for devices and monitoring.

Only 1% of patients on traditional Medicare use remote physiologic monitoring, the more common form of remote monitoring, and the cost makes up a small share of overall spending. But both are growing quickly.

The number of traditional Medicare patients enrolled in these programs grew tenfold from 2019 to 2023, while spending rose from just under $7 million to more than $194 million, according to an April 2025 Peterson Center on Healthcare report.

Pearson said the evidence shows remote monitoring is most useful when providers use the data to guide treatment — such as changing medications — and only until a patient is stable.

“We shouldn’t be paying for doctors to be reviewing huge numbers of readings, for years on end, for patients that have controlled blood pressure,” Pearson said.

“That doesn’t feel like a clinically driven decision. That feels like a revenue decision,” she said, adding that some vendors openly pitch their services as a way for health facilities to generate income.

But traditional Medicare patients are staying in remote physiologic monitoring programs longer. From 2019 to 2023, the average length of time increased from 1.7 months to 5.2 months, the Peterson report found.

Pearson said Medicare should limit how long patients can remain in remote monitoring unless there is evidence the care is still needed. She also said the agency should require clinicians to report more data, including outcomes.

She said Medicare should eventually move toward a payment model that ties reimbursement to whether programs improve patients’ health. Pearson said CMS has already started moving in that direction through its new ACCESS program, which pays clinicians as well as vendors.

But Pearson said the program, which launched in July, pays less than traditional models.

Williams said the government should keep remote monitoring available.

“It looks like they’re cutting off everybody, and that’s not right,” she said.