The public comment period on a Medicare proposal that would stop paying for remote patient monitoring performed by outside vendors closed Monday night, and a coalition of more than 230 health care organizations warns that the change could disrupt care for more than 1 million beneficiaries. That estimate comes from the coalition, not from the Centers for Medicare & Medicaid Services (CMS), which tied the proposal to concerns about program integrity and low-quality vendors.
Under the draft 2027 Physician Fee Schedule, Medicare would pay for remote physiologic monitoring and remote therapeutic monitoring only when the services are furnished by clinical staff employed by the billing practice, starting January 1, 2027, Fierce Healthcare reported on the proposed Medicare changes. Practices could no longer bill Medicare when that work is contracted out to third-party companies.
Remote monitoring lets patients collect health data, such as blood pressure or weight, with a connected device that automatically sends the readings to their clinicians. For adult children helping a parent manage heart failure or high blood pressure, the practical question is whether that program will still exist next year.
Billing Concerns Behind the Medicare Proposal
CMS pointed to program integrity concerns. A 2025 HHS Office of Inspector General report found that Medicare payments for remote patient monitoring exceeded $500 million in 2024. Citing that report, Fierce Healthcare noted that payments rose 31% in one year, from $408 million in 2023 to $536 million in 2024, and that nearly 1 million enrollees received the services in 2024.
Federal investigators had raised concerns earlier. A 2024 OIG evaluation found that about 43% of enrollees who received remote monitoring did not receive all three components of the service, raising questions about whether it was being used as intended. The OIG also noted that both it and CMS have raised concerns about fraud involving remote patient monitoring.
Provider and technology groups say the proposed fix goes too far. In a coalition letter to CMS Administrator Dr. Mehmet Oz, organized by the Alliance for Connected Care, signers warned that restricting access would push Medicare back toward more expensive emergency visits, hospital stays, and institutional care. "A policy intended to strengthen oversight should not increase costs to taxpayers," the letter states. The coalition urged CMS to delay the policy and work with stakeholders on more targeted safeguards.
Rural Clinics and Small Practices Could Be Hit Hardest
The groups say small practices, rural providers, and safety-net organizations depend most on outside partners because they cannot easily hire dedicated monitoring staff. ATA Action, the advocacy arm of the American Telemedicine Association, warned in its comments to CMS that the changes could make remote monitoring "financially and operationally unworkable" for many physician practices and health systems. The group said many would be forced to reduce enrollment, end programs, or stop offering monitoring altogether.
ATA Action also cited a children's hospital whose remote monitoring department manages about 300 patients each month across 17 programs, including children with heart transplants and type 1 diabetes. The group said patients could lose established connections with their care teams and face enrollment delays after a hospital stay or a new diagnosis.
The proposal also overlaps with new state spending. According to an Alliance for Connected Care analysis cited by Fierce Healthcare, 22 states have announced roughly $240 million in remote monitoring funding through the $50 billion Rural Health Transformation Program, and 35 states have identified more than $2.4 billion in broader technology investments that could support monitoring. The Alliance argues that states may struggle to meet program goals if rural hospitals cannot use vendors.
What the Evidence Shows and What Remains Unclear
Clinical research generally supports remote monitoring for some patients. A 2025 meta-analysis in JMIR mHealth and uHealth pooled 40 randomized controlled trials and found that remote monitoring likely reduced the share of patients hospitalized, the number of hospitalizations, and the length of hospital stays compared with usual care. A separate review cited by Fierce Healthcare found that monitoring in heart failure care decreased hospitalizations and improved quality of life.
Those studies do not answer the narrower question CMS is raising. They were not designed to compare monitoring run by a practice's own employees with monitoring run by contractors, so they cannot show whether outcomes would change under the new staffing rule. The coalition's estimate of more than 1 million affected beneficiaries is an advocacy figure that MedicalDaily could not independently verify, and CMS has not finalized the rule.
Several questions remain open, including how many practices would hire staff rather than close programs, whether CMS will delay the policy as the coalition requested, and how the change would affect state rural health plans. The broader payment rule had drawn nearly 40,000 comments on the federal comment docket as of Monday, according to Fierce Healthcare.
Steps Patients Can Take Before the Final Rule
Nothing changes for patients today. If you or a parent uses a home monitoring device, keep using it as directed and keep sending readings. Ask the doctor's office whether the program is run by its own staff or an outside company, and whether the practice has a plan for 2027.
Watch for possible fraud. Be cautious about unsolicited calls offering free monitoring devices, and review Medicare Summary Notices for monitoring charges you do not recognize.
Do not wait for a care team to call if readings look dangerous. A very high blood pressure reading with chest pain, shortness of breath, severe headache, confusion, or weakness on one side of the body needs emergency care. People with heart failure who notice sudden weight gain or worsening breathing should contact their clinician promptly.
People in Medicare Advantage plans may see different arrangements than those in traditional Medicare, so it is worth asking the plan how it handles monitoring before Medicare open enrollment begins on October 15. CMS usually releases its final physician payment rule around the beginning of November, ahead of the January 1 effective date. MedicalDaily will report whether the agency keeps, changes, or delays the vendor restriction and what that means for patients already enrolled.
Key Questions Answered
What is Medicare proposing? Starting January 1, 2027, Medicare would pay for remote physiologic and therapeutic monitoring only when the services are furnished by clinical staff employed by the billing practice. Work contracted out to third-party companies could not be billed.
How many people could be affected? A coalition of more than 230 health organizations estimates that more than 1 million Medicare beneficiaries could see their care disrupted. Federal investigators found that nearly 1 million enrollees received remote monitoring in 2024. CMS has not confirmed the coalition's estimate.
Will my monitoring stop right away? No. The rule is still a proposal. If adopted as written, the change would take effect January 1, 2027.
Why does CMS want the change? CMS cited concerns about program integrity and low-quality vendors. Federal reports found rapid spending growth and many patients who did not receive all required parts of the service.
Who could be hit hardest? Provider groups say rural hospitals, small independent practices, federally qualified health centers, and safety-net providers would struggle most because many rely on outside partners for staffing.
What should patients do now? Keep using your device as directed, ask your doctor's office who runs the program and what it plans for 2027, check Medicare statements for unfamiliar charges, and seek emergency care for dangerous readings with symptoms.
