Facing Fierce Criticism, UnitedHealthcare Postpones RPM Coverage Limits
- 3 days ago
- 2 min read
UnitedHealthcare (UHC), one of the nation's largest health insurers, has temporarily delayed the implementation of sweeping changes aimed at restricting coverage for Remote Patient Monitoring (RPM) services. The policy change, originally slated to take effect on January 1, 2026, was intended to significantly narrow coverage, impacting millions of members across commercial, individual exchange, Medicaid, and Medicare Advantage (MA) plans.
Under the initial proposal, UHC asserted that remote monitoring for conditions such as chronic obstructive pulmonary disease (COPD), diabetes (specifically Type 2), and hypertension (unrelated to pregnancy) was “unproven, and not medically necessary,” and would therefore no longer be covered. The policy stated that coverage would only continue for patients diagnosed with heart failure or hypertensive disorders of pregnancy, where research demonstrates clear clinical value.
The announcement of these planned cuts triggered a fierce groundswell of criticism from healthcare providers, advocates, and legal experts. Providers argued that UHC was ignoring clinical research showing that RPM improves patient outcomes and lowers costs for a spectrum of chronic conditions.
A major point of contention centered on Medicare Advantage plans. Legal experts asserted that applying the new restrictions to MA enrollees was a seemingly clear violation of Centers for Medicare & Medicaid Services (CMS) policy. Federal regulations require that MA organizations must cover all services covered by traditional Medicare (Part A and Part B), and traditional Medicare currently covers remote patient monitoring. The sources indicate that UHC may have recognized this clear violation, as the online link for the MA policy within UHC’s documentation yielded a “404 page not found” error.
On December 17, 2025, UHC notified its members via email that the new policy’s effective date would be delayed, and a future effective date would be communicated later. This pause offers a critical, short-term reprieve, allowing practices to continue billing UHC for RPM for chronic conditions like hypertension and diabetes under current policies. However, stakeholders are cautioned that the delay is merely a postponement of coverage removal, not a revival of full coverage, meaning the underlying restrictions could still be implemented at a future date. The industry pressure must continue to ensure the best outcome for the millions of patients who rely on these services.
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UnitedHealthcare Postpones RPM Coverage Limits
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