Oig Urges Stronger Safeguards As Remote Patient Monitoring Billing Rises

As home-based care providers increasingly adopt remote patient monitoring (RPM), watchdogs are heightening scrutiny of potential fraud in billing for these services.

The Department of Health and Human Services Office of Inspector General (OIG) recently conducted a review into RPM billing and found that Medicare paid out over $500 million for RPM services in 2024. Based on its findings, the OIG developed additional measures designed to root out waste, fraud and abuse relating to RPM services.

For its review, the OIG examined Medicare fee-for-service claims from Jan. 1, 2024 through Dec. 31, 2024. The analysis focused on claims and encounters billed with one or more RPM procedure codes.

The OIG’s review found that Medicare payments for RPM have seen consistent growth every year since 2019. Additionally, almost 1 million Medicare enrollees received RPM in 2024, a 27% increase from 2023.

OIG stated that these findings point to the need for more oversight.

In a previous report, the OIG recommended that the U.S. Centers for Medicare and Medicaid Services (CMS) conduct periodic analysis to identify providers who frequently bill for enrollees who do not receive all the components of RPM.

In this report, the OIG also suggested that CMS should take steps to ensure Medicare only pays for appropriate RPM services.

It also recommended that CMS work with Medicare Advantage plans to ensure they have the right safeguards in place.

The OIG’s recommendations also include that all RPM services be ordered by a physician or other qualified health care professionals, as well as developing methods to identify what health data are being monitored.

“Using measures – such as the ones in this report – to monitor billing for remote patient monitoring can help safeguard program integrity and prevent fraud, waste, and abuse,” the OIG wrote in the report. “Further, this approach can help CMS, Medicare Advantage organizations, and other entities ensure that enrollees receive the benefit of remote patient monitoring while, at the same time, minimizing program integrity risks.”

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