Insurance giant UnitedHealthcare has pushed pause on a decision to roll back remote monitoring coverage after significant backlash by the industry.
Earlier this fall, UnitedHealthcare quietly pushed out a drastic change to how it pays for remote monitoring services in its Medicare Advantage and commercial insurance plans. While it has traditionally paid for the use of the devices in the treatment of many chronic and acute conditions, the insurer abruptly announced that there is not enough evidence to support coverage of the technology.
UHC seems to have rethought this decision. On Wednesday, it pushed out an email saying that the reduced coverage plan has been delayed from Jan. 1, 2026, until later in the year. The email, widely shared on LinkedIn, says UHC will send out an advanced notice of its ultimate coverage decision with a new effective date “later in 2026.”
When UHC first announced its intent to roll back RPM coverage for all services except hypertensive disorders of pregnancy and chronic heart failure, the coverage determination document laid out pages worth of evidence for the decision.
The document included a slew of studies that the insurer said could not point to clear benefits for the use of the services. The evidence document listed out studies of RPM for conditions like diabetes mellitus, gestational diabetes, hypertension, chronic obstructive pulmonary disease (COPD) and mental health conditions; it concluded that, “remote physiologic monitoring is unproven and not medically necessary due to insufficient evidence of efficacy.”
While some groups, like the Bipartisan Policy Center and the Peterson Health Technology Institute, have recommended putting caps on remote monitoring payment—i.e., only paying for the service until the condition is stabilized—they acknowledge evidence that RPM is effective in helping control chronic conditions.
A study in Health Affairs, published on Wednesday, said that the decision “misreads the evidence and jeopardizes care.” The authors said UHC misstated the American College of Cardiology’s guidelines on the use of technology for measuring blood pressure at home.
“The only plausible explanation here is that UHC is taking advantage of nuances in RPM terminology to invalidate the entire technology class by conflating technology wraparounds (apps) with core devices (home blood pressure cuffs) and clinical services (telemedicine),” they wrote.
UHC used the evidence to support the decision to stop covering the majority of RPM services. The insurer said it has legal footing to do so, even though Medicare Advantage plans are required to cover the same services as traditional Medicare, because the Centers for Medicare and Medicaid Services has not made a national coverage determination (NCD) or local coverage determination (LCD) for RPM.
“I think that particular response is not an appropriate characterization of the statute,” Emily Cook, a lawyer at McDermott Will & Schulte that helped write MA regulations, said in November. “When there is an NCD or an LCD, it is clear that the Medicare Advantage plans are required to follow the NCD or the LCD, but that doesn't mean when there's not an NCD or LCD, it's a free-for-all.”
MA plans have some discretion at the individual member level to determine if a service rendered was medically necessary for the patient.
“There are provisions that allow for a narrow scope of services where there is the ability to make those medical necessity determinations,” she said. “That is not what is happening with this UnitedHealthcare plan. This UnitedHealthcare plan is ruling out the ability to cover certain diagnoses for RPM without doing any individualized patient analysis.”