Senators Urge CMS to Reconsider the 2027 Remote Patient Monitoring Staffing Proposal

On September 23, 2026, Senators Mark R. Warner (D-VA) and Marsha Blackburn (R-TN) sent a bipartisan letter to CMS Administrator Mehmet Oz urging the agency to reconsider proposed Remote Patient Monitoring (RPM) changes in the Calendar Year (CY) 2027 Medicare Physician Fee Schedule proposed rule, filed as CMS-1848-P.

Their central objection is the staffing provision, which would require RPM clinical services to be furnished by staff employed by the billing practitioner or that practitioner’s practice, ending the contracted staffing arrangements many practices use today. The senators argue the restriction would fall hardest on hospitals and on rural, small, and independent practices, and that it works against other federal efforts to expand technology-supported care.

Below is what the senators asked for, who else objected during the comment period, and what practices should watch before the final rule.

Senators Warner and Blackburn Asked CMS Not to Finalize the Policies as Proposed

The letter does not ask CMS to abandon oversight. It asks the agency not to finalize the remote monitoring policies as proposed, and to work with beneficiaries, providers, and other stakeholders on targeted safeguards instead.

The senators singled out the staffing restriction, asking CMS to reconsider what they called the “limits on remote monitoring staffing” and to build program integrity standards that reach bad actors while preserving access. The ask is a framework that protects against waste while “preserving flexible staffing models.”

The senators also raised a sequencing problem. The HHS Office of Inspector General found in 2024 that Medicare “lacks key information for oversight” of RPM and issued five recommendations for collecting it. The senators argue CMS should implement those data recommendations first, then design guardrails based on what the data shows, rather than imposing a blanket employment restriction now.

The 2027 Staffing Proposal Would Change Who May Furnish RPM Services

CMS released CMS-1848-P on July 14, 2026, and it was published in the Federal Register on July 16. Alongside the staffing provision, the rule proposes an initiating visit requirement, revised valuations for several codes, and a request for comment on consolidating the RPM and remote therapeutic monitoring (RTM) code sets into new HCPCS G-codes.

Together these would be the most significant restructuring of remote patient monitoring billing since Medicare began paying for the service.

Nothing in the proposal is in effect. Practices bill under current rules until CMS publishes the final rule, expected around November 1, 2026.

Rural and Small Practices Are at the Center of the Concern

The senators’ argument rests on workforce capacity. Rural and independent practices often lack the internal staff to run an RPM program entirely in-house, so they contract for patient onboarding, device support, data review, alert management, documentation, and clinical escalation.

An employment-only requirement would ask those practices to absorb that work with staff they do not have, on a timeline measured in weeks.

The letter also points to a policy conflict. The House Ways and Means Committee unanimously advanced the Rural Patient Monitoring Access Act, the House companion to legislation Warner and Blackburn introduced in the Senate. HHS is separately working with states on the $50 billion Rural Health Transformation Program, under which many states plan technology investments that include RPM devices and supporting infrastructure.

The concern is that one federal policy would restrict the care model another federal program is funding. Rural health organizations have made the same point. The National Rural Health Association has called for delays to the proposed policies and pointed to H.R. 3108 and S.1535 as a more balanced path. Practices serving these populations can read more in DrKumo’s coverage of rural health and FQHCs and RHCs.

More Than 230 Organizations Raised the Same Objections During the Comment Period

The comment period closed on September 14, 2026. By that date, a sign-on letter organized by the Alliance for Connected Care had gathered more than 230 healthcare organizations, including roughly 35 health systems, national patient advocacy groups, and provider societies. That letter asked CMS to delay the remote monitoring policies and work with stakeholders on proportionate, evidence-based guardrails.

The Warner and Blackburn letter arrived nine days after the comment deadline and adds a congressional voice to that record. The American Association of Nurse Practitioners, Bipartisan Policy Center Action, UVA Health, VCU Health, Sovah Health, and Highpoint Health all provided supporting statements alongside the release.

Several of those statements raised the same two-part request: better data on how RPM is being used, then targeted oversight based on it.

What the Letter Could Mean for Practices Running RPM Programs

A letter from two senators does not change a regulation. CMS is required to respond to comments in the final rule, and congressional pressure is one input among many.

The practical reading for providers is that the staffing provision is contested enough that its final form is uncertain, and planning should account for more than one outcome.

Steps practices can take while the final rule is pending:

• Document which parts of your RPM workflow are performed by employed staff and which are contracted, so you can model either outcome.
• Review vendor agreements for terms that would need renegotiation if clinical monitoring time has to shift in-house.
• Confirm that your documentation already shows the ordering practitioner, patient consent, device supply, and the clinical time furnished for each patient enrolled.
• Track the final rule at CMS rather than relying on secondhand summaries, and revisit 2027 staffing plans once it publishes.

How DrKumo Supports RPM Program Delivery

DrKumo provides secure, HIPAA-compliant digital health technology that supports remote patient monitoring programs operated by healthcare providers. The platform moves physiologic data from patients’ homes to care teams over cellular connectivity, using medical devices as defined by the FDA, including blood pressure monitors, glucometers, and weight scales.

Because the technology supports a practice’s own clinical staff rather than substituting for them, organizations that employ their monitoring staff can use the same platform under either version of the staffing rule.

DrKumo also supports provider-led Disease Management Protocols for conditions common among Medicare beneficiaries, including hypertension, diabetes, heart failure, and COPD, and applies healthcare cybersecurity practices to the handling of patient data. For community providers and rural organizations weighing how the CY 2027 rule may affect their programs, DrKumo can offer context on how monitoring technology fits alongside evolving CMS payment policy.

DrKumo is a technology provider and is not a clinical entity. Providers retain full clinical responsibility for patient care decisions, and RPM supports monitoring between visits rather than replacing emergency care.

Key Takeaways

Senators Warner and Blackburn asked CMS on September 23, 2026 to reconsider the remote monitoring provisions of the CY 2027 Medicare Physician Fee Schedule proposed rule, with particular focus on the requirement that RPM clinical services be furnished by employed staff.

Their argument is that hospitals and rural, small, and independent practices often lack the internal workforce to run these programs alone, and that the restriction conflicts with the Rural Patient Monitoring Access Act and the Rural Health Transformation Program. They asked CMS to implement the 2024 OIG data recommendations before imposing a blanket employment requirement.

More than 230 organizations made similar requests during the comment period, which closed September 14, 2026. Nothing has changed in current billing rules. The final rule is expected around November 1, 2026, with any finalized policies taking effect January 1, 2027.

Frequently Asked Questions About the Senate Letter on RPM Staffing

Questions about the letter and what it means for practices running remote monitoring programs.

References

U.S. Senate. (2026). Warner, Blackburn Urge CMS to Reconsider Proposed Restrictions on Remote Patient Monitoring. Warner.senate.gov.

Warner, M. R., and Blackburn, M. (2026). Letter to CMS Administrator Mehmet Oz on CY 2027 PFS Remote Monitoring Proposals. Warner.senate.gov.

Centers for Medicare & Medicaid Services. (2026). CY 2027 Medicare Physician Fee Schedule Proposed Rule (CMS-1848-P). CMS.gov.

Centers for Medicare & Medicaid Services. (2026). Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule Fact Sheet. CMS.gov.

U.S. Department of Health and Human Services, Office of Inspector General. (2024). Additional Oversight of Remote Patient Monitoring in Medicare Is Needed. OIG.HHS.gov.

Remote Monitoring Stakeholder Coalition. (2026). 2027 PFS Remote Monitoring Stakeholder Sign-On Letter, September 14. Hosted by AASM.org.