Insurers defend remote monitoring they tried to cut

Major US health insurers are opposing a Medicare proposal that would change how doctors bill for patient monitoring using devices like connected blood pressure cuffs, scales and glucose meters. Remote patient monitoring (RPM) helps patients manage hypertension, diabetes and heart failure.

UnitedHealth Group, CVS Health and Kaiser Permanente wrote to the Centers for Medicare and Medicaid Services to oppose the plan. It requires the practice submitting the claim to deliver care through its own employees. This effectively bans subcontractors. All three groups run both insurance and care businesses.

An internal contradiction

UnitedHealth Group’s objection stands out. Its insurance subsidiary, UnitedHealthcare, recently tried to stop paying for most RPM, citing "insufficient evidence of effectiveness." The same company now plays two roles: a payer questioning the service’s value and a care provider defending the billing model.

For patients, the stakes are practical. Remote monitoring works when it catches a decline without a visit. Consider a heart failure patient whose weight change signals fluid retention. If a third party delivers the service but the practice bills for it, responsibility becomes unclear. Who reacts to the alert? Who documents it? Who answers for the outcome? The proposal shifts these duties to the billing practice.

The dispute is not about the devices. It is about who may bill for their use. Patients can still measure blood pressure or weight at home. The question is whether an outside company can interpret the data, or only the practice’s staff. As care becomes a purchased service, this determines who maintains contact with the patient and who bears the risk if an alert is missed.

Meanwhile, the agency promotes the ACCESS program, paying for chronic disease management based on outcomes. Medicare is shifting focus from service volume to results. Yet the tools used to achieve those results face conflicting regulatory signals.

The practical impact on patients is limited. Devices still work and data still reach the record. What changes is which entities can analyze and bill for that data. This affects how quickly a patient gets a response from someone who knows their history.