Thomas Ferrante on RPM Reimbursement – ‘The hesitation right now is whether the juice is worth the squeeze’

Foley & Lardner LLP partner Thomas Ferrante offered insight on the debate over how remote patient monitoring technology will be reimbursed in the Modern Healthcare article, “Remote patient monitoring faces reimbursement hurdles.”

Ferrante said that while the U.S. Centers for Medicare and Medicaid Services (CMS) has added more remote patient monitoring billing codes since the first one was introduced in 2018, the agency is still trying to understand how to reimburse the technology.

“A lot of the industry folks, particularly these new [remote patient monitoring] vendors or the more tech-oriented startup companies, they want to move fast,” Ferrante explained. “And that’s just not how health care in the United States operates.”

Ferrante noted that one of the reasons why there has been hesitancy from CMS and others over expanding reimbursement is the concerns raised by the U.S. Justice Department’s Office of Inspector General over companies using remote patient monitoring codes fraudulently.

“The hesitation right now is whether the juice is worth the squeeze,” Ferrante said. “Is this worth the cost? Are we actually improving in moving the needle here for what we’re paying for?”

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