OIG Calls for Increased Oversight of Remote Patient Monitoring
The OIG recently issued a report that found patient monitoring in Medicare has been increasing dramatically and that nearly half the of enrollees who received remote patient monitoring did not receive all the required components, calling into question whether providers are using monitoring as intended. There is currently limited research on the use of remote patient monitoring services, such as the types of patients and providers who use these services and the health conditions that are monitored through these services, among other details. The OIG called for CMS to take the following steps to strengthen oversight of remote patient monitoring:
- Implement additional safeguards to ensure that remote patient monitoring is used and billed appropriately in Medicare.
- Require remote patient monitoring be ordered and information about the ordering provider be included on claims and encounter data for remote patient monitoring.
- Develop methods to identify what health data is being monitored.
- Conduct provider education about billing for remote patient monitoring.
- Identify and monitor companies that bill for remote patient monitoring.
The following are factors that need to be considered in connection with remote monitoring reimbursement:
- Remote patient monitoring coverage includes Medicare and most state Medicaid programs.
- Understanding the reimbursement rates for remote monitoring.
- Ensuring proper CPT coding (e.g., service codes, management codes).
- Following CMS Guidelines for remote patient monitoring (e.g., charging co-payments, gaining patient consent, service being ordered by a qualified health professional, monitoring period, and data synchronization).
- RPM devices used must meet FDA use standards.
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