Insurers Opposed Medicare Remote Monitoring Billing Rule
Major health providers seek to preserve third-party contractor models for remote patient monitoring services.
Updated on Sept. 23, 2026 in Healthcare
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Should Medicare restrict medical providers from using third-party contractors for remote patient monitoring services?
UnitedHealth Group, CVS Health, and Kaiser Permanente have formally opposed a Medicare proposal that would require remote patient monitoring services to be provided exclusively by direct employees. The change would effectively ban the use of third-party contractors for tracking conditions like diabetes and heart failure.
Why it matters
The proposal threatens to dismantle the outsourced staffing models many practices use to scale remote care. This regulatory push arrives as insurers continue to scrutinize the clinical efficacy of these digital health services.
Three major healthcare entities, including UnitedHealth Group, CVS Health, and Kaiser Permanente, filed formal opposition to the Medicare proposal. The policy would restrict the billing of remote patient monitoring services solely to practices using direct employees.
The players
UnitedHealth Group
A diversified healthcare giant operating the largest private insurer in the United States.
CVS Health
A national retail pharmacy and healthcare services provider that manages extensive integrated care networks.
Kaiser Permanente
A major integrated managed care consortium providing comprehensive health services across the United States.
Centers for Medicare and Medicaid Services
The federal agency responsible for setting reimbursement standards and billing regulations for the U.S. healthcare system.
The details
The proposed CMS rule mandates that practitioners must use in-house staff to deliver remote monitoring for chronic conditions such as hypertension and heart failure. This move would prohibit the current industry practice of outsourcing monitoring functions to specialized third-party contractors. By requiring direct employment, the rule increases the overhead costs for providers who currently lean on external vendors to handle high-volume data streams.
Timeline
September 2026: Major insurers submitted opposition letters to CMS.
Market Landscape
This proposal marks a departure from the current flexibility allowed under the Centers for Medicare and Medicaid Services' remote patient monitoring billing framework. It follows ongoing skepticism from insurers like UnitedHealthcare regarding the established efficacy of remote monitoring programs.
Practices relying on third-party remote monitoring vendors should prepare for potential increases in internal staffing costs or billing denials. Consult with legal counsel or accounting teams to evaluate how current outsourcing contracts align with these proposed federal staffing mandates.
The takeaway
The proposed rule signals a federal move to centralize clinical accountability by linking billing eligibility to direct employment status. Operators should track whether CMS moves to finalize this restriction or if industry pushback forces a transition toward a less restrictive oversight model.
Further reading
For broader analysis on changing reimbursement policies, review our Healthcare section.
Live Poll
Should Medicare restrict medical providers from using third-party contractors for remote patient monitoring services?
