WATCHDOG: MORE SCRUTINY NEEDED — More oversight of remote patient monitoring — which took off since the pandemic — is needed, a government watchdog said. Remote monitoring often leans on connected devices like blood pressure cuffs and glucose monitors that can track a patient’s vital signs and other data. The details: In a new report Tuesday, HHS’ Office of Inspector General found that Medicare payment for RPM grew 20 times between 2019 and 2022 — rising from $15 million to $311 million. The overwhelming majority of patients — 94 percent — used RPM for chronic conditions, according to HHS’ OIG. Amid the growth in use, close to half of enrollees didn’t get all three steps that the watchdog says make up RPM: education and setup, at least 16 readings a month and provider review of the data. “Although CMS does not require that providers bill for all three components, the high percentage of enrollees who did not receive all components raises questions about whether these services are being used as intended,” the watchdog wrote. Recommendations: HHS’ OIG called on CMS to add more safeguards to ensure RPM is being used appropriately and require that information about the ordering provider be added to claims data to prevent waste, fraud and abuse. CMS said it agreed with or would consider all the recommendations. The bigger picture: The findings come as lawmakers look to avoid fraud while they promote expanded access to digital health technologies like RPM and telemedicine. The OIG has previously reported that telehealth fraud was rare during the pandemic. Its Tuesday report said that a lack of transparency makes it more difficult for CMS to detect fraud and abuse in RPM. The reaction: Lobbying group the Alliance for Connected Care is calling on OIG to consider retracting the report, saying the watchdog shows bias in its report and doesn’t accurately reflect how RPM services must be delivered in Medicare. “We would be happy to work with you on designing and recommending tools to address the real fraud that is happening in the Medicare program,” the group’s founder, Krista Drobac, wrote in a letter Tuesday. “Better control of inappropriate Medicare enrollment, solicitation, and prescribing while instituting stronger monitoring and audits to ensure fraudulent providers are caught sooner and weeded out of the system.” FIRST IN PULSE II: HHS COMPETITION OFFICER MOVES TO SENATE FINANCE — HHS’ first chief competition officer is headed to Capitol Hill to serve as chief health adviser on the Senate Finance Committee majority staff next month, Chelsea reports. Stacy Sanders will join the committee in mid-October, according to Senate Finance Chair Ron Wyden’s (D-Ore.) office. Sanders is leaving HHS 10 months after she was named the department’s chief competition officer, tasked with overseeing HHS’ implementation of the Inflation Reduction Act and policies to promote health care competition. Both President Joe Biden and Vice President Kamala Harris, in their respective presidential campaigns, have touted the Medicare price negotiations as a cornerstone of their health care policies. Harris, since becoming the Democratic presidential nominee, has said she would push for negotiations to cover more drugs. Before becoming chief competition officer, Sanders was a counselor to HHS Secretary Xavier Becerra and, before that, a staff director on the Senate Special Committee on Aging. “I look forward to ensuring every American family can afford the health care they need, shedding light on the actions of concentrated middlemen, promoting Americans’ access to behavioral health and long-term care, and more,” Sanders said in a statement.
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