32 House Lawmakers Warn Rural Medicare Patients Could Lose Home Blood Pressure and Glucose Monitoring Under CMS Plan

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Most of the evidence was low certainty. cottonbro studio | Pexels Share on Twitter Share on Facebook Share on Pocket A bipartisan group of 32 House members is pressing Medicare to rethink a proposal that could disrupt remote monitoring for older adults who send blood pressure and blood sugar readings to their doctors from home. In an Oct. 2 letter to CMS Administrator Dr. Mehmet Oz, the lawmakers warned that rural patients and small practices could be hit hardest, Becker’s Hospital Review reported.

The proposal is not final. If adopted as written, Medicare would pay for remote monitoring starting Jan. 1, 2027, only when clinical staff employed by the billing practice do the work, not outside companies. For a small-town patient whose blood pressure cuff or glucose meter sends readings automatically, the question is whether the doctor’s office could keep the program running on its own.

Developing Story Note: This report covers new congressional pressure on a proposed Medicare remote monitoring rule. Information may change as CMS releases its final 2027 payment rule. Latest verified update: Oct. 6, 2026.

The letter was led by Republican Reps. David Kustoff of Tennessee and Troy Balderson of Ohio, and its signers include Democratic Reps. Mark Pocan of Wisconsin and Yvette Clarke of New York. “We are concerned that a blanket prohibition on partnering clinical staff could inadvertently disrupt the care delivery models that CMS and the states are working to build,” the lawmakers wrote, according to Fierce Healthcare. They added that the change “could push care back toward more costly emergency departments and institutional settings.”

The House letter follows a Sept. 23 letter from Sens. Mark Warner, a Virginia Democrat, and Marsha Blackburn, a Tennessee Republican, who wrote that “these vendors are not mere middlemen.” CMS typically finalizes its physician payment rule in early November, leaving about two months before any change would take effect.

MedicalDaily previously reported on the warning from more than 230 health groups when public comments closed in September. Since then, the fight has moved to Capitol Hill.

A patient takes a reading at home, the connected device sends it to the care team, and staff review the numbers and follow up when something looks off. The HHS Office of Inspector General (OIG) describes the service as having three parts: patient education and device setup, the device itself, and treatment management.

Under the CMS proposed rule fact sheet, released July 14, Medicare would pay for remote monitoring only “when performed by clinical staff employed by the practice and not when those services are delivered by contractors.” CMS would also require an initiating visit when monitoring begins and would lower payment values, saying the devices may now cost less than it first estimated. CMS has said the change is meant to address program integrity concerns and low-quality vendors.

Those concerns have a documented basis. In a 2024 review of Medicare remote monitoring, the OIG found that about 43% of enrollees who received remote monitoring did not receive all three components. A 2025 OIG follow-up found that Medicare payments rose 31% to $536 million in 2024, when nearly 1 million enrollees used the services.

The lawmakers cited a National Association of Rural Health Clinics survey finding that nearly 70% of rural health clinics offering remote monitoring rely on outside clinical and technology partners. Rural patients often face long drives and few clinicians, which can make at-home readings more important. A coalition letter posted by the Medical Group Management Association warned that “Small practices, rural providers, and safety-net organizations would be hit hardest.”

An Alliance for Connected Care analysis found that 22 states have announced roughly $240 million in monitoring funding through the federal Rural Health Transformation Program. Meanwhile, Kustoff’s Rural Patient Monitoring Access Act cleared the House Ways and Means Committee in July but has not become law.

The House letter also cited a published study warning that losing access to a high-quality monitoring program could raise hospitalizations by 27%. The lawmakers noted that the OIG flagged concerning billing patterns at just 0.68% of practices that routinely bill for monitoring, which they said calls for targeted attention, “not sweeping changes.”

Nothing changes today. Patients should keep using their devices as directed and should not adjust medication without speaking with a health care professional. Caregivers can ask who reviews the readings and who calls when a number is out of range.

Patients can also ask whether the office plans to keep its program in 2027, whether a new initiating visit would be needed and what it might cost, and what happens if monitoring ends. A written log of readings is a useful backup that can be shared at any regular or telehealth visit. People enrolled in Medicare Advantage can compare plans during open enrollment, which begins Oct. 15.

A single reading is not always an emergency, but symptoms can be. Very high blood pressure with chest pain, a severe headache or trouble speaking, or low blood sugar causing confusion or fainting needs urgent care through 911.

CMS could finalize, change, or delay the policy within weeks. For rural families, the most useful step now is a short conversation with the care team before that decision.

What is new in this story? On Oct. 2, 32 House members asked CMS to rethink its proposed limit on outsourced remote monitoring, following a Sept. 23 Senate letter raising similar concerns. CMS has not issued a final decision.

What would the proposed rule change? If finalized, Medicare would pay for remote monitoring only when staff employed by the billing practice do the work, starting Jan. 1, 2027. It would also add an initiating visit and lower payments.

Who could be most affected? Rural patients and patients of small practices that rely on outside partners could face the biggest disruption, especially those managing high blood pressure or diabetes at home.

Should I stop using my home monitor? No. The proposal is not final. Keep using your device as directed and raise any concerns with your care team.

When will Medicare decide? CMS typically releases its final physician payment rule in early November. Most provisions would take effect Jan. 1, 2027.