Federal Policy
CMS Proposes Ban on Medicare Payment for Third-Party Remote Patient Monitoring
CMS has issued a proposed rule that would prohibit Medicare payment for remote patient monitoring services delivered by third-party vendors. Health systems, physician groups, and telehealth trade associations are opposing the proposal, citing concerns about disrupted RPM programs and unclear reimbursement alternatives. The proposal has prompted some organizations to pause RPM expansion plans and appears to conflict with congressional support for broader telehealth access. If finalized, the policy would require Medicare providers to deliver RPM services directly rather than through vendor arrangements.
Why it mattersMedicaid MCOs that have adopted Medicare-aligned remote patient monitoring programs or vendor partnerships may face operational changes if states follow CMS policy direction, particularly for dual-eligible and managed LTSS populations relying on RPM for chronic disease management.