OIG Alerts, RPM, Medicare and Your Practice: The Impact

Remote Patient Monitoring (RPM) has grown into a $500 million market in 2024, underscoring the remarkable demand for connected care solutions. This growth is more than just a number—it reflects a structural shift in how Medicare is approaching primary care.

 

By Editor-in-Chief, Concierge Medicine Today/The DocPreneur Leadership Podcast

 

Fall/Winter 2025 - In many ways, RPM and Chronic Care Management (CCM) represent Medicare’s attempt to move primary care away from a purely fee-for-service model and toward a capitated, ongoing care structure built around a flat monthly fee. It’s not concierge medicine, but in practice, it mirrors some of the principles: continuous monitoring, proactive management, and stronger patient-provider connection.

 

Unlike CCM, which has seen slower traction, RPM adoption has been swift and widespread. The Office of Inspector General (OIG) has expressed concerns in recent reports, but this very scrutiny highlights the scale of adoption and the significant investment in ongoing monitoring that the U.S. healthcare system has never truly embraced before. 📑 Source: OIG RPM Report, 2025 (View: https://oig.hhs.gov/reports/all/2025/billing-for-remote-patient-monitoring/) 

 

In addition, the April 2025 OIG report marked the fourth prosecution in U.S. history related to cash-based healthcare models. This case provides perhaps the clearest signal yet from OIG that traditional concierge-style marketing—emphasizing same- or next-day access, extended visits, care coordination, and direct physician communication—is not compliant with Medicare assignment rules unless it is paired with proper, routine exam structuring.

 

FOR ADDITIONAL REFERENCE and LEARNING, here is the 4th OIG alert in US history: https://oig.hhs.gov/fraud/enforcement/greenfield-health-system-agreed-to-pay-286000-for-allegedly-violating-the-civil-monetary-penalties-law-by-requesting-payment-from-beneficiaries-in-violation-of-an-assignment-agreement/

 

Together, these developments point to a pivotal moment: Medicare is nudging primary care toward connected, ongoing models of care delivery, while simultaneously tightening compliance expectations around concierge-style offerings. For physicians, the message is clear—connected care is here to stay, but compliance and structure are non-negotiable.

 

About Our Guest

 

James Eischen, Esq (Jim Eischen) is a licensed California attorney with over 32 years of experience handling complex corporate, business planning, and real estate matters. He received his J.D. from the University of California at Davis in 1987, and his B.A. from Creighton University in 1984.

 

Mr. Eischen is recognized nationally for compliance experience regarding complex corporate business planning and transactions. As a speaker at conferences throughout the US, he addresses data privacy, regulatory business planning problem-solving, and start-up innovation monetization.

 

Mr. Eischen’s broad complex business planning experience includes life science/start-up enterprise regulatory support and structuring corporate practice of medicine business modeling. He advises business enterprises in matters connected to reimbursement, contracts, interdisciplinary employment and labor issues, and Health Insurance Portability and Accountability Act (HIPAA) compliance.

 

LEARN MORE (https://www.eischenlawoffice.com)

 

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