A recent proposal from the Centers for Medicare & Medicaid Services has presented Congress with an opportunity to address two important priorities: protecting access to lifesaving care for patients who need it most and ensuring taxpayer dollars are spent responsibly. As a geriatric nurse practitioner, I know how important it is for patients to receive the care they need, but I also believe we have a responsibility to protect Medicare from waste, fraud, and abuse. By embracing new technologies and strengthening accountability, we can better serve patients while ensuring taxpayer dollars are used as intended.
To accomplish both goals, we must protect access to remote patient monitoring.
Remote patient monitoring, or RPM, allows healthcare professionals to monitor a patient’s health data using a digital device, even if they’re away from the patient’s bedside. This technology is especially valuable for patients in rural communities who may live far from the nearest hospital or healthcare facility. By allowing providers to monitor chronic conditions and intervene when necessary, RPM helps patients receive timely care without requiring frequent trips to the doctor’s office.
This is especially important in rural America, where patients often face long drives, limited specialty care, and fewer local clinicians. A 24/7 clinical monitoring model can help a patient receive timely attention while remaining at home instead of waiting until a worsening condition forces a hospital visit. Certain responsible leaders in the space have seen hospital admissions among those patients drop by over 27%.
To preserve these benefits, both parties in Congress must work with CMS to protect access to these services for over 1 million Americans, many of whom are rural seniors managing serious conditions such as heart disease, cancers, and hypertension.
When utilized correctly, RPM helps patients stay healthy at home, reduces preventable hospitalizations, and lowers Medicare costs. While concerns about waste, fraud, and abuse in RPM deserve attention, the solution is stronger oversight and accountability to ensure Medicare dollars go toward patient care, not bad actors. Medicare should never pay for a stream of data that no clinician meaningfully reviews, or a billing arrangement in which the physician has little relationship with the patient and no accountability for the care delivered. Plus, patients deserve to know that a qualified clinician is reviewing their data, and taxpayers deserve transparent billing so as not to subsidize the bad actors who provide inferior service.
To address these concerns, CMS has proposed allowing Medicare payment for RPM only when the clinical work is performed by staff directly employed by the billing physician or practice. While intended to strengthen oversight, this change could prevent practices that rely on contracted clinical teams from receiving reimbursement for these services. Paired with new visiting requirements and a restructuring of billing codes by CMS, this industry could cease to exist, erasing countless gains and throwing millions of families, providers, districts, and states into debt.
If the proposed 2027 Physician Fee Schedule change under consideration at CMS were to proceed, cancellation notices could begin going out to older patients in Virginia, North Carolina, Michigan, Texas, and dozens of other states with rural populations in late October. In the Commonwealth of Virginia, where I represent the 2nd Congressional District, thousands of patients would be affected. Moving forward, CMS should also consider how these changes could impact the Rural Health Transformation Program, a key component of last year’s working families’ tax cut. The program includes over $50 billion in investments to strengthen rural healthcare, including expanding access to telehealth and other digital health services.
The question is not whether Washington should act, but how. Policymakers must focus on holding bad actors accountable without undermining the legitimate programs that help seniors stay healthier at home and reduce Medicare costs. That includes programs Congress and the administration have previously supported through significant federal investments to improve patient care and expand access to healthcare services.
The industry needs strong guardrail policies, and the administration should partner with Congress and honest brokers in the healthcare industry to create them. But a blunt prohibition on contracted clinical staff will not accomplish those goals. CMS already has the advanced tools to distinguish accountable care from unaccountable billing. Rather than impose a sweeping employment test, CMS should focus on whether a real clinician is accountable for a real patient. For example, they could require that RPM services be documented in the patient’s electronic health record, and not whether every member of the care team appears on the same payroll.
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In this Congress, we have made modernizing rural healthcare and rooting out waste, fraud, and abuse key priorities, and I remain committed to advancing both. CMS has an opportunity to get this right: protect taxpayers by targeting abusive practices, demand real clinical accountability, and preserve the technology-enabled care that helps seniors avoid needless hospital stays.
This is a win for Medicare, a win for rural patients and providers, and, most importantly, a win for the millions of patients who want to remain healthy at home. I encourage CMS to reconsider this policy change or at least delay its implementation to allow more time for further discussion. As commonsense conservatives, we can eliminate waste, fraud, and abuse while preserving access to innovative healthcare services that improve patient outcomes and protect taxpayer dollars.
Rep. Jen Kiggans has represented Virginia’s 2nd District since 2023. Prior to entering Congress, she was a geriatric nurse practitioner who cared for seniors and gained firsthand experience navigating the challenges patients and healthcare providers face. As vice co-chairwoman of the Congressional Nursing Caucus, she remains committed to improving healthcare affordability, expanding access to quality care, and protecting Medicare for America’s seniors.