OIG: More oversight needed on remote patient monitoring in Medicare

The Department of Health and Human Services’ Office of Inspector General Sept. 24 recommended that additional oversight is needed to ensure that remote patient monitoring in Medicare is being used and billed appropriately, according to a report. The report found that the number of Medicare enrollees who received RPM was more than 10 times higher in 2022 (570,000) than in 2019 (55,000). About 43 percent of enrollees who received RPM did not receive all three components of it, raising questions about whether the monitoring is being used as intended, the report said. OIG also determined that Medicare lacks key information for oversight, including who ordered the monitoring for the enrollee. Both OIG and the Centers for Medicare & Medicaid services have raised concerns about fraud related to RPM. 

The report doesn't provide details on whether anomalous billing practices were concentrated in a select group of billing providers. However, it mentions that some bad actors may be engaging in unscrupulous practices, notably RPM companies that make unsolicited contact with beneficiaries to enroll them in RPM. "Most often, the monitoring never happens, but the company bills for remote patient monitoring anyway," the report notes. Other recommendations in the report included developing additional provider education on billing codes, increasing transparency of incident to billing, requiring an order and collecting additional data on equipment and vitals measured.