A bipartisan group of 32 House lawmakers is pressing CMS Administrator Mehmet Oz to roll back proposed Medicare payment changes that would bar remote patient monitoring programs from using third-party clinical staff.

The lawmakers argue the proposal could significantly reduce access to remote monitoring for Medicare beneficiaries, particularly rural patients and those served by small, independent physician practices and hospitals.

Representatives David Kustoff, R-Tenn., and Troy Balderson, R-Ohio, drafted the bipartisan letter, signed by 30 other members of Congress, calling out a CMS proposal that would block third-party vendors from remote patient monitoring.

In July, the Centers for Medicare and Medicaid Services (CMS) proposed changes to remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) reimbursement that stakeholders say would make many programs difficult to sustain. The policy change, tucked inside a hefty Medicare physician pay draft rule, marks a shift with far-reaching implications for RPM companies, primary care physicians, hospitals and health systems by eliminating third-party vendors.

Under the draft rule, Medicare will only allow payment for RPM and RTM services when furnished by clinical staff employed by the practice, effective January 1, 2027.

If finalized, for the purposes of billing Medicare, the RPM and RTM codes could not be billed in cases where the service is not performed by clinical staff of the billing practitioner and will not allow contracting out to third-party companies, regulators wrote in the draft rule.

CMS said the change was necessary to address concerns about program integrity and vendors offering low-quality care.

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