Foley & Lardner LLP partner Thomas Ferrante commented in the Medscape article, “Remote Patient Monitoring: How to Stay on the Right Side of Oversight,” offering perspective on regulatory expectations and enforcement trends for remote patient monitoring (RPM) services.
Ferrante emphasized that medical necessity is the compliance standard regulators focus on. “Some organizations that have been investigated treated RPM like a subscription, billing month after month,” he said. “That’s not how Medicare views compliant billing. The expectation is that monitoring is tied to a care plan and adjusted as the patient’s condition evolves.”
He noted that enforcement has increased. “In the last 18 months, we’ve had at least half a dozen government audits, when before we saw very few,” Ferrante explained. “Large health systems are also auditing their vendor relationships after government warnings. They sometimes find no documentation of interactive communication or required data thresholds weren’t met, which has led to self-reporting and repayment.”
While recent coding refinements have made compliance more realistic by better reflecting actual patient data transmission patterns and management time, Ferrante stressed that the core requirements remain unchanged. “Document the treatment plan, show that the data informed decisions, and make sure the service is reasonable and necessary,” he added. “That’s what survives an audit.”
