backOIG Publishes Report Reiterating the Need for Oversight in Remote Patient Monitoring
On August 28, 2025, OIG published a report titled “Data Snapshot: Billing for Remote Patient Monitoring in Medicare.” According to the report, Medicare claims and expenditures for remote patient monitoring increased significantly in 2024 over the year prior. Based on this data, OIG echoed its previous calls for greater oversight in remote patient monitoring to minimize program integrity risks. The report describes five measures OIG has developed for monitoring claims data to ensure compliance with Medicare’s payment requirements for remote patient monitoring. OIG tested those measures against the 2024 claims data and included the results in its report.
Remote patient monitoring, also known as “remote physiologic monitoring,” refers to use of equipment by patients to collect their own health data (from the comfort of their home) and transmit it to their health care provider. The provider uses that data to remotely treat or manage the patient’s condition. Medicare allows providers to bill for that treatment if the patient has a chronic or acute condition that requires monitoring. Providers can also bill Medicare for the equipment and the time spent training the patient to use it.
Medicare began covering remote patient monitoring services in 2018. Each year since, claims and outlays for these services have increased dramatically. In a separate report published last year, OIG reported that since 2019, the number of enrollees receiving remote patient monitoring services and the total Medicare expenditures for those services had increased by ten and twenty-fold, respectively. OIG concluded at that time that this dramatic increase in claims and expenditures warrants additional oversight.
OIG reiterated this concern in its report published last Friday. The report indicates that the number of enrollees receiving patient monitoring services increased by 27 percent in 2024. OIG’s report also says that Medicare payments for remote patient monitoring were $536 million in 2024, which represents a 31 percent increase over the year prior. “These data provide further support for the findings and recommendations in our first report which found that the use of these services in Medicare has the potential to greatly expand and that additional oversight is needed.”
OIG’s report from last week describes five measures that OIG developed to monitor claims data for remote patient monitoring. OIG used these measures to review the claims submitted by 4,639 medical practices that routinely billed for remote patient monitoring in 2024. The report includes OIG’s analysis of those measures.
The first measure monitors significant increases in enrollees. OIG found that 32 of the sampled medical practices increased the number of new enrollees for whom the practice billed remote patient monitoring by over 150 percent in a single month during 2024. OIG said that while increases of this magnitude could represent legitimate growth, it can also be a “marker of fraud,” and “signal a need for further scrutiny.”
Second, OIG calculated the percentage of enrollees with whom the medical practices did not have a prior relationship before billing remote patient monitoring. CMS requires that at least one provider in the practice must have an in-person or telehealth visit with the patient before the practice can bill for remote patient monitoring. OIG found that among the sampled practices, 45 did not have a prior relationship with more than 80 percent of the patients for whom they billed remote patient monitoring in 2024.
Third, OIG measured the percentage of enrollees for whom the practice billed for remote patient monitoring equipment and education but did not bill for treatment management. OIG found that 52 of the sampled practices did not bill treatment management for more than 75 percent of their enrollees. OIG found that this warrants further scrutiny to ensure that remote patient monitoring is being used effectively to treat the enrollee’s condition.
Fourth, OIG identified 32 practices that were billing remote patient monitoring services for the same enrollee as two or more other practices. This “raises concern that they may be billing for monitoring that is not necessary or not provided.” Fifth and last, OIG found 20 practices that were billing for more than one remote patient monitoring device, even though Medicare only allows practices to bill for only one remote patient monitoring device per month per enrollee. This, according to OIG, “may indicate that practices are double billing for the same device, or billing for devices that are not provided or not medically necessary.”
Notably, the majority of claims OIG analyzed appeared not to warrant further scrutiny. The report identified potentially problematic claims at less than four percent of the 4,639 medical practices that routinely billed for remote patient monitoring in 2024. OIG’s focus on outliers suggests that most claims appear to have been billed for services that were in line with program requirements.
OIG’s report concludes that the continued increase in Medicare claims and spending for remote patient monitoring services warrants the implementation of measures like the five described in the report to strengthen oversight of these services and minimize program integrity risks.
A copy of OIG’s report is available here.
Reporter, Alek Pivec, Washington, D.C., +1 202 626 2914, apivec@kslaw.com.
OIG Urges CMS to Strengthen Oversight of Postoperative Visit Reporting
In August 2025, OIG released report A-05-20-00027, evaluating whether CMS is receiving the postoperative visit data that it requires from practitioners subject to Medicare’s global surgical package reporting rules. OIG’s findings highlight oversight gaps and carry important implications for compliance and payment policy.
Background
Congress, through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), directed CMS to collect data on the number and level of postoperative visits furnished during global surgical periods. The purpose of this requirement was to ensure that the valuation of global surgical packages accurately reflects the services provided. In response, CMS required practitioners in nine states to begin reporting postoperative visits for select high-volume or high-cost procedures in July 2017. These data are intended to inform CMS’s evaluation of payment policies for global surgical services.
Key Findings
OIG found that CMS cannot confirm whether it is receiving all required postoperative visit data from practitioners. Under the reporting program, practitioners were expected to submit postoperative visit information for designated procedures, but CMS did not have controls to verify compliance.
OIG’s audit of a stratified random sample of claims identified multiple reporting failures:
- Some practitioners furnished postoperative visits but did not submit CPT code 99024 as required. OIG noted that this occurred, for example, when a physician performed surgery in a private practice but the postoperative care was furnished in a clinic not associated with that practice, and the billing staff did not have access to the relevant medical record.
- Other practitioners submitted CPT 99024 but reported an incorrect number of visits compared to what was documented in the medical record.
- OIG also found instances where the medical record did not align with the reporting. In some cases, visits were omitted from the record altogether, while in others, postoperative visits were misclassified, such as being reported separately as evaluation and management services rather than as global postoperative visits.
Because CMS does not have a process to notify practitioners when required postoperative data have not been reported, these gaps go undetected. OIG concluded that CMS may therefore be relying on incomplete or inaccurate data when evaluating whether global surgery payments reflect the services actually delivered. Based on its sample results, OIG estimated that Medicare paid about $7.8 million more (Medicare patients paid about $4.8 million more) than would have been paid if global surgery fees had reflected the actual number of postoperative visits.
Implications for Practitioners
The OIG report underscores that practitioners subject to postoperative visit reporting requirements must ensure complete and accurate submission of data. Although the audit focused on CMS’s oversight, the findings highlight several risks for the provider community:
- Compliance risk. Practitioners who fail to report postoperative visits as required may face heightened scrutiny from CMS or future OIG audits.
- Payment policy impact. Because CMS relies on these data to evaluate whether global surgery payment rates reflect actual practice, incomplete reporting could contribute to changes in the structure or valuation of global surgical packages in future rulemaking.
- Operational considerations. Practitioners should review their processes for capturing, documenting, and reporting postoperative visits—particularly the use of CPT 99024—to ensure alignment with CMS requirements.
By reinforcing reporting practices now, practitioners can reduce compliance risk and be better prepared for potential changes to Medicare payment policy.
Reporter, Francis Han, New York, +1 212 556 2154, fhan@kslaw.com.
Also In The News
King & Spalding Welcomes David Hoskins, Former Lead Litigation Counsel for CMS
King & Spalding welcomes David Hoskins as a Partner in our Washington, D.C. office. Mr. Hoskins is the former Deputy Associate General Counsel for Litigation in the Office of General Counsel for CMS where he oversaw all litigation against the federal Medicare and Medicaid programs.
For more than 20 years, Mr. Hoskins has also defended CMS in litigation related to the Affordable Care Act and the Inflation Reduction Act, including managing and litigating hundreds of “rate-setting” challenges brought by health providers, advising senior government officials on the matters, and negotiating settlements with the private parties challenging them.
More information on Mr. Hoskins is available here.
Upcoming Events
King & Spalding 12th Annual Cybersecurity & Privacy Summit
Tuesday, September 30 at 10:00 A.M. – 6:00 P.M. ET
- In-Person & Virtual
Join King & Spalding for the 12th Annual Cybersecurity & Privacy Summit, an immersive program dedicated to sharing key lessons, best practices, and the latest critical trends shaping the world of cybersecurity and privacy. This year, our theme “Navigating the Future: Empowering Innovation, Protecting Data and Prioritizing Privacy” sets the stage for insightful dialogue and practical guidance.
The Summit will feature distinguished data, privacy and security lawyers; in-house counsel; and leading industry experts who will focus on balancing innovation with risk management, sharing insights into new and upcoming privacy regulations, exploring the evolving threat landscape and more. Mark your calendar and join us for a dynamic program designed to address the most pressing issues in the field.
Further program announcements will follow, with the full agenda to be released in the coming weeks.
Please RSVP by September 19. The page to RSVP for the summit can be found here. For questions, contact the K&S Events Team.
King & Spalding Health Law & Policy Forum West
Wednesday, October 15, 8:30 A.M. – 6:00 P.M. PT
- The Ritz-Carlton, Marina del Rey
Join our distinguished faculty and industry leaders for our annual Health Law & Policy Forum West in Marina del Rey. As the healthcare industry continues to evolve in response to economic pressures, patient needs and accelerating technological advances, this full-day program will cover the trending topics that lawyers, executives, managers and investors need to know as they adapt to changes associated with the new administration and more. A keynote session featuring Chad Golder, general counsel of the American Hospital Association, and Rob Hur, former special counsel and U.S. attorney, and current King & Spalding partner, will discuss key issues facing the healthcare industry. Additionally, our partner Rob DeConti, former chief counsel to the Department of Health and Human Services (HHS OIG), will provide his insights into the OIG’s enforcement priorities and share his thoughts on emerging enforcement trends and compliance issues.
Attendees will also enjoy multiple networking opportunities, including a reception following the sessions.
Register by September 5. Registration is available here and is $95 per person. For questions, contact the K&S Events Team.
Editors: Chris Kenny and Ahsin Azim
Issue Editors: Jenna Anderson and Doug Comin