Some physicians are expressing concern that regulation around remote monitoring has not caught up with the boom of use in the last two years, KFF Health News reported March 18.
Remote monitoring's boom was sparked during the height of the COVID-19 pandemic and has outpaced oversight and evidence of how best to use it, according to experts.
"It is the Wild West, where any patient can get it if a doctor decides it is reasonable or necessary," Caroline Reignley, a partner with the law firm McDermott Will & Emery who advises health providers, told KFF Health News.
In 2019, Medicare made billing for remote monitoring for routine vital signs easier and removed some of the previous limitations. Physicians can get paid for services even when monitoring is done by clinicians in different places than the physicians.
In the first two years since the changes were made, remote monitoring services that billed Medicare grew from less than 134,000 to 2.4 million. Total payments for the four most common billing codes related to remote monitoring rose from $5.5 million in 2019 to $109.4 million in 2021, the latest data available. About 400 physicians billed Medicare repeatedly for patient remote monitoring in 2019, but in 2021, that number bloomed to about 3,700 providers.
At about $100 per month per patient, Medicare payments for remote monitoring can add up for physicians, incentivizing its use. It can also help free up scheduled appointments.
Federal law enforcement officials are conducting investigations into a surge of complaints from patients using remote monitoring, including complaints that some companies sign up Medicare enrollees without their physicians' knowledge and billing Medicare even when no monitoring occurs.
A January report from the Bipartisan Policy Center think tank warned about "a lack of robust evidence on the optimal use of remote monitoring" and said some experts "question whether we are effectively 'rightsizing' the use of these services, ensuring access for patients who need it most, and spending healthcare dollars in effective ways."
Meena Seshamani, MD, PhD, director of the Center for Medicare, part of the CMS, did not tell KFF Health News how the agency plans to ensure only patients who benefit from remote monitoring receive it, but she noted that the agency balances the need to give patients access to emergency technologies with the need to combat fraud and make proper payments to providers.
Meanwhile, some physicians said that up to 75% of their patients find remote monitoring helpful.