Remote Patient Monitoring (RPM): Appropriate Use and Potential Fraud

Remote patient monitoring (RPM) is the ability for healthcare providers to track aspects of a patient’s health outside traditional clinical settings, like the patient’s home. RPM can reduce the need for in-person visits, cut down on travel costs, and limit exposure to illness, which can be especially helpful for people with chronic conditions or mobility challenges.

Providers may collect data such as heart rate, blood glucose, blood pressure, or breathing rate, and then use it to help manage conditions and guide treatment decisions between visits. Although RPM can be a useful part of care when used appropriately, there are areas for potential fraud. Some services may be offered without clear medical need, may be explained incompletely, or may be billed in ways that do not reflect the level of care provided. In some situations, this may rise to the level of fraud; in others, it may involve overuse or misunderstandings about consent and billing.

Patients may be contacted by companies through phone calls, online ads, social media, or television promotions offering RPM services or devices. While some of these offers are legitimate, others are misleading, especially if they emphasize “free” products or request personal or Medicare information without involving the patient’s regular provider. Look out for the following potential fraud or scam warning signs:

• You see charges on your Medicare statements for remote (physiologic or therapeutic) monitoring you didn’t need, you didn’t get, you didn’t agree to, or that were from a provider you do not know.
• You are offered a “free” device that tracks your daily steps, like a smart watch, in exchange for your Medicare number or other personal information.
• You are told RPM services are free to Medicare beneficiaries and then RPM services are billed to Medicare.
• Your doctor’s office calls to ask how you are doing. Later, you notice they billed the phone call to Medicare as an RPM service.

If you have questions about Medicare’s telehealth coverage, contact the Council on Aging at 256-845-8590 and speak to Lynn Hixon.