In recent years, there has been an increase in the utilization of what is known as “remote patient monitoring” throughout the healthcare industry. Remote patient monitoring allows patients to collect and submit their own health information directly to providers through a specialized medical device that automatically transmits relevant data to the doctor’s office. The convenience afforded by remote patient monitoring makes it particularly useful for patients dealing with chronic conditions, which may limit their ability to make frequent visits to providers, but otherwise require regular monitoring in order to be treated. In anticipation that this industry trend will result in an increase in Medicare claims for patient monitoring services, the Office of the Inspector General (OIG) issued a report regarding the management of such data for Medicare recipients, recommending specific measures for CMS to take in order to reduce the risks of fraud and abuse that may seem inherent in the provision of such services. Specifically, the measures recommended by the OIG are aimed at ensuring that Medicare recipients receive each of the three individual components of remote patient monitoring that Medicare is billed for.
Per the OIG report, remote patient monitoring services require the following components in order to facilitate the effective treatment of patients: (1) setting up the monitoring device and training the patient on how to use it, (2) device supply and (3) the ongoing use of the device in the patient’s treatment. While the OIG considers each of these components essential, the OIG recently found that 43% of patients failed to receive at least one, despite the fact that Medicare paid for the whole service. Such a troubling statistic necessarily begs the question of whether the services are being used as intended. In order to confirm that the services are being properly administered to Medicare patients and therefore properly paid out by Medicare, the OIG report recommends that CMS take the following steps:
- Implement additional safeguards to ensure that remote patient monitoring is being used and billed appropriately.
- Require remote patient monitoring be ordered and that information about the provider submitting the order 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 of remote patient monitoring.
- Identify and monitor companies that bill for remote patient monitoring.
In response to the OIG’s recommendations, CMS has stated that it would take the above recommendations into consideration. Although it is unclear whether any of the above will actually be implemented by CMS, let alone when such safeguards will be implemented, providers who regularly service Medicare patients and/or use remote patient monitoring in the treatment of these patients should keep this in mind so they are prepared if and when new requirements are implemented.
How Frier Levitt Can Help
As the healthcare industry is constantly changing, the regulatory landscape must evolve in order to keep up. Frier Levitt attorneys closely monitor industry and regulatory trends to make sure that providers are adequately informed of any updates and the potential impact of these updates to their operations. If you have questions about this advisory opinion or any other regulatory updates, contact our office to speak with an attorney today.
