In late 2025, a major Medicare Advantage plan announced a significant change in its remote physiologic monitoring (RPM) coverage policy that would have dramatically narrowed reimbursement for RPM services, limiting coverage to only patients with chronic heart failure and hypertensive disorders of pregnancy while excluding common chronic conditions such as hypertension, Type 2 diabetes, COPD, and more. The plan justified the change by asserting that RPM for these conditions was “unproven and not medically necessary,” a stance that contradicted existing clinical evidence and federal policy direction.
The Remote Monitoring Leadership Council (RMLC) was a leading voice in opposition to this rollback. In the months leading up to and following the announcement, the RMLC engaged in multi-front advocacy efforts designed to highlight RPM’s clinical value, economic impact, and alignment with evidence-based chronic care management:
Additionally, stakeholders across the health care system raised concerns that the proposed coverage restriction represented an aggressive departure from Medicare fee-for-service policy, which continued to recognize RPM as a broadly applicable care management tool. Stakeholders also noted that the decision appeared to rely on a narrow interpretation of evidence while discounting a substantial body of clinical guidelines, outcomes data, and real-world experience. If implemented, the policy would have cut off patient access to essential monitoring services and set a troubling precedent for future payer-driven exclusions of technology-enabled care.
Concerns were echoed by leading health policy and clinical experts, including:
- Federation of American Hospitals: CMS Regulations and Medicare Advantage Coverage Policy
- Health Affairs: Remote Monitoring Rollback Misreads The Evidence And Jeopardizes Care – Authored by the lead author of the 2020 guidelines, cited in the coverage decision policy
- American Heart Association: 2025 Multi-Specialty Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
As of December 2025, following sustained stakeholder engagement, the Medicare Advantage plan temporarily delayed implementing its restrictive RPM coverage policy.
The RMLC continues to lay the groundwork to ensure that patients do not lose access to RPM services, advocating for coverage policies that reflect clinical evidence, federal payment policy, and the central role of remote monitoring in modern chronic disease care. The RMLC is defending RPM today and shaping the future of RPM. If you’re interested in protecting patient access and advancing evidence-based remote care, please reach out to rcheung@rpmleadershipcouncil.org.