In a letter to Dr. Schaening, the American Telemedicine Association and Alliance for Connected Care Telehealth have expressed worries regarding the upcoming Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) meeting scheduled for February 28, 2023. The groups have expressed their disappointment with the process and requested modifications to the Local Coverage Decision (LCD) process.
The groups have identified several key concerns, including the absence of critical studies from the bibliography and the brevity of the scheduled discussion. Furthermore, the grouping of RPM and RTM into one meeting is concerning, as the Medicare Administrative Contractors may not understand how health care providers operate to deliver high-quality care. This, coupled with the absence of certain clinical conditions and disease states from consideration, may complicate access to remote patient monitoring.
The groups have urged the committee to consider their recommendations for modifications and highlighted that the use of remote patient monitoring in managing post-hospitalization patients and those with ongoing chronic diseases is essential to better health outcomes. RPM and RTM technologies provide better patient compliance and improved ability for physicians to manage care outside of the institution.
The Local Coverage Determination process was changed to promote transparency, clarity, consistency, reduce provider burden, and improve public relations while still allowing for responsiveness to local clinical and coverage policy concerns. However, the advocacy groups are worried that the CAC’s advice may not result from a complete scientific inquiry, nor will it ensure an unbiased or modern assessment of state-of-the-art technology and science.
In addition, the groups note that the bibliography is missing 45 reliable studies, including works from some of the most reputable physicians using RPM. The groups have requested that the committee re-issue the list with a more comprehensive examination of the literature, including the documents attached to their letter. They argue that the allocated meeting time is too short for a meaningful discussion of the topic, especially with RPM and RTM combined into one meeting. The groups have also suggested that the committee allocate more time for an introduction by experts with “on the ground” experience with remote monitoring. They believe that an inclusive discussion with CAC members on RPM and RTM experiences and efficacy will have immense benefit to Medicare Administrative Contractors, other policymakers, and the public.
The American Telemedicine Association and Alliance for Connected Care Telehealth are determined to work alongside the committee to advance policy that benefits the public by bringing the advantages of digital health technologies, including RPM and RTM, to American patients equitably. “We believe that an inclusive discussion with CAC members on RPM and RTM experiences and efficacy, consistent with the above, will have immense benefit to MACs, other policymakers, and the public”, the letter states. “We request your partnership in advancing policy that will bring the benefits of digital health technologies, including RPM and RTM, to American patients equitably.”
