In a letter to agency administrator Mehmet Oz, U.S. senators Mark Warner, D-Virginia, and Marsha Blackburn, R-Tennessee, urged the agency to reconsider sweeping changes to remote patient monitoring that was proposed earlier this summer, arguing that it would limit access to care for rural Medicare recipients and negatively affect rural hospitals, while running counter to the technology-enabled reforms being put forward in the Rural Health Transformation program.
In September, more than 230 healthcare organizations, hospitals and advocacy groups sent their own letter, arguing that the proposed change would eliminate the program for some rural residents, make healthcare more inaccessible for those in rural communities and disrupt care for an estimated 1 million Medicare beneficiaries.
The National Rural Health Association was one of the organizations signing on to the letter. The letter urged the Medicare and Medicaid agency to reconsider the proposal based on its impact on patients in rural and underserved communities; the letter was organized by the Alliance for Connected Care, Hartford (Connecticut) HealthCare and Somerville, Massachusetts, based Mass General Brigham, as well as St. Louis-based Ascension, Norfolk, Virginia, based Sentara Health, and Palo Alto, California, based Stanford Health Care,.
“From a patient perspective, we have seen a growth … use of remote patient monitoring services in rural areas,” said Carrie Cochran-McClain, chief policy officer with the National Rural Health Association, in an interview with the Daily Yonder.
”Monitoring of vital functions or care or even some level of service provided in home through these services really can make a difference (to rural patients) and their ability to have a high quality of life while staying in their local rural community.”
Remote patient monitoring is a growing health care service that uses real-time data and telehealth to help rural patients with acute and chronic conditions access health care providers without having to travel to hospitals or clinics. Advocates for the technology say it allows patients to take control of their care and prevents them from ending up in the emergency room when chronic conditions escalate.
However, earlier this year, the Centers for Medicare and Medicaid, a division of the U.S. Department of Health and Human Services, proposed changes to the 2027 Medicare Physician Fee Schedule that would make it harder for providers to offer remote monitoring services by restricting who can handle those services.
The federal agency proposed cutting off Medicare payment for third-party vendors who provide remote patient monitoring. If the proposal is finalized, Medicare would only pay for remote monitoring when the clinical staff furnishing the service is employed by the billing practice. Agency officials say the change was necessary to address concerns over vendors and the program’s integrity. Payments for remote patient monitoring increased from $408 million in 2023 to $536 million in 2024, a 31% increase. The program had nearly 1 million participants in 2024, up 27% over the number of enrollees in 2023.
On October 6, 2026, more than two dozen U.S. representatives wrote in a separate letter to CMS that the proposal was an over-reaction to miniscule pattern of flagged billing; the lead writers of the letter were U.S. representatives David Kustoff, R-Tennessee; Troy Balderson, R-Ohio; Mark Pocan, D-Wisconsin; and Yvette Clarke, D-New York. The lawmakers wrote that the Health and Human ServicesOffice of Inspector General had reviewed the data behind the push for more oversight, and found it centered on just 0.68% of remote monitoring billing. The representatives instead called for “sensible and targeted attention to the issue, not sweeping changes.”
The representatives warned in their letter that losing access to the remote patient monitoring could increase hospitalization 27%, and raise the total cost of care by more than $1,300 per patient per year.
In public comments, and in correspondence to the Medicare agency, many healthcare organizations expressed concern that the proposal could eliminate remote monitoring for some patients. More than 43,000 comments on the proposed rule change were received before the comment period closed in September.
“If finalized, many (rural health centers) indicated they would no longer be able to provide such services to their patients, and it is also likely to significantly impact future uptake of these needed services in rural communities where additional staffing presents unique challenges that are often alleviated through third-party partnerships,” the National Association of Rural Health Clinics argued in public comments about the proposed changes.
In addition, the Congress members said the proposal runs counter to what Congress and Health and Human Services are working to do – specifically to expand access to technology-related care in rural communities.
“These services allow clinicians to monitor patients between visits, identify worsening conditions earlier, and intervene before a patient requires an emergency department visit or hospitalization,” senators Warner and Blackburn wrote. “Congress, states, and providers are working to expand technology-enabled care, strengthen the rural health workforce, modernize health information infrastructure, and support care in the home. Remote monitoring is central to these rural health transformation efforts.”
Their counterparts in the House agreed. Recently, the House Ways and Means Committee unanimously advanced the Rural Patient Monitoring Access Act, to ensure rural patients have access to remote monitoring services. That legislation has also been introduced in the Senate.
The proposed changes run counter to what states are doing with the Rural Health Transformation Program funding from the federal government as well. More that 20 states have announced or awarded an estimated $240 million in funding dedicated specifically to rural-patient monitoring infrastructure, and 35 states have announced funding opportunities using Rural Health Transformation Program money that identify rural-patient monitoring as an allowable use of those funds, according to Prevounce, a technology consulting company that assists hospitals in managing their remote patient monitoring programs.
Opponents to the proposed change urged the Medicare agency to instead improve its collection of information about how remote patient monitoring is provided and implement targeted guardrails to prevent fraud, waste and abuse without negatively impacting rural providers who are already challenged in how they can serve their patients.
The Centers for Medicare and Medicaid did not return requests for comment. If finalized, the proposed changes would go into effect on January 1, 2027.
The post Lawmakers, Hospitals Say Medicare and Medicaid Changes Would Hurt Rural Hospitals appeared first on The Daily Yonder.
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