UnitedHealthcare Halts Remote Monitoring Coverage for Diabetes, Hypertension

The insurer’s new policy, effective January 1, 2026, limits RPM coverage to two conditions: chronic heart failure and hypertensive disorders during pregnancy.

UnitedHealthcare has rolled back coverage for remote patient monitoring (RPM) under its Medicare Advantage plans, ending reimbursement for diabetes and hypertension care. The insurer’s new policy, effective January 1, 2026, limits RPM coverage to two conditions: chronic heart failure and hypertensive disorders during pregnancy.

“Starting Jan. 1, 2026, we will cover remote physiologic monitoring only for members diagnosed with heart failure or hypertensive disorders during pregnancy, based on the latest clinical evidence,” a UnitedHealthcare spokesperson told Fierce Healthcare. “We’ll continue to cover home monitoring devices according to members’ benefit plans and encourage providers to work with their patients to manage their health with proven, effective care.”

The document outlining UnitedHealthcare’s policy states that remote physiologic monitoring is “unproven and not medically necessary due to insufficient evidence of efficacy” for a range of conditions, including diabetes mellitus, gestational diabetes, chronic obstructive pulmonary disease, and mental health conditions.

Legal and health policy experts have raised concerns that the move could create a precedent for restricting other Medicare Advantage benefits. “This is a far more restrictive policy than the type of limitations we’ve seen in the past,” said Emily Cook, a lawyer at McDermott, Will & Emery who helped write Medicare Advantage regulations.

Cook added, “The statute very, very clearly says that Medicare Advantage plans are required to cover all of the benefits that are available through traditional Medicare.” She argued that UnitedHealthcare’s interpretation — that MA plans can make different coverage determinations when no national or local coverage determinations exist — “is not an appropriate characterization of the statute.”

According to TJ Ferrante, partner at Foley & Lardner, the change could harm patients who rely on physician-prescribed monitoring. “These patients are getting remote monitoring because the doctors deem it appropriate. That’s why the doctors are ordering it,” he said. “It would be very harmful to, I think, tens of thousands of patients, probably.”

The new policy contrasts with the Centers for Medicare & Medicaid Services’ ongoing support for remote monitoring since its introduction in 2019. CMS has expanded RPM coverage to encourage preventive care and chronic disease management — a direction supported by multiple clinical studies showing reduced hospital admissions and cost savings through RPM use.

Industry stakeholders have alerted CMS about UnitedHealthcare’s policy, but the agency has not yet responded publicly. If challenged, CMS could enforce penalties against UnitedHealth Group for potential violations of Medicare Advantage coverage requirements.

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