What Providers Need to Know
- UnitedHealthcare (UHC) has temporarily delayed its planned RPM coverage restrictions.
- The proposed January 1, 2026 effective date is no longer in place.
- Providers may continue billing UHC for RPM services for hypertension, diabetes, COPD, and other chronic conditions until further notice.
- Sustained advocacy from clinicians, health systems, and industry leaders—including coordinated efforts through the Remote Monitoring Leadership Council (RMLC)—played a critical role in pushing this issue into federal scrutiny.
Earlier this year, UnitedHealthcare announced plans to significantly restrict Remote Physiologic Monitoring (RPM) coverage, limiting reimbursement to patients with heart failure or hypertensive disorders of pregnancy. Under that proposal, millions of patients managing chronic conditions such as hypertension, diabetes, and COPD would have lost access to RPM services.
On December 17, 2025, UHC notified providers that it is delaying implementation of these changes, which were previously slated to take effect on January 1, 2026. UHC indicated that a new effective date will be communicated at a later time.
While formal policy documentation has not yet been updated, this delay provides a meaningful—though temporary—reprieve for providers and patients who rely on RPM as part of chronic disease management.
Why This Delay Matters
This pause prevents an abrupt disruption of care for millions of patients currently supported through RPM programs. More importantly, it signals that payer policy is not immune to scrutiny when evidence, alignment, and urgency converge.
At CoachCare and MD Revolution, we believe this moment reinforces what providers have long known: RPM is not a niche service—it is a clinically validated, evidence-based model that improves outcomes, supports care teams, and reduces downstream costs across a wide range of chronic conditions.
The Role of Advocacy—and Why It Worked
The delay did not happen in a vacuum.
Physicians, health systems, policy experts, and RPM leaders raised serious concerns that UHC’s proposed restrictions:
- Deviated materially from Traditional Medicare coverage standards
- Ignored decades of clinical evidence supporting RPM
- Threatened patient access at a critical moment for connected care
As part of this effort, CoachCare’s CEO, Andrew Zengilowski, in his role as a co-founding member of the Remote Monitoring Leadership Council (RMLC), worked directly with clinicians, health systems, and industry leaders to elevate these concerns and push them into federal and regulatory review.
This coordinated advocacy helped ensure the issue was evaluated not just as a reimbursement change, but as a patient access and evidence-based care issue.
The result:
A pause—and a clear signal that continued engagement matters.
What the Delay Means—and What Is Still at Stake
It’s important to be clear: this is a delay, not a resolution.
Providers may continue billing UHC for RPM services under current policy for now. However, UHC has stated it intends to revisit RPM coverage later in 2026, with advance notice before any changes take effect.
This window should be used strategically.
Providers may consider:
- Reviewing current RPM populations to understand potential future exposure
- Continuing to document outcomes and clinical value tied to RPM programs
- Staying engaged with industry advocacy efforts that protect patient access and evidence-based care
At CoachCare and MD Revolution, we remain actively engaged to ensure any future policy changes support—not undermine—patients, providers, and the long-term viability of connected care.
We will continue monitoring developments closely and will share updates as more information becomes available. In the meantime, follow us on LinkedIn or contact us any time for an open discussion.
