UnitedHealth To End Some Coverage For Remote Patient Monitoring Devices
Contrary to the positive reimbursement trends coming out of CMS, UnitedHealth announced that from Jan. 1, only members with heart failure or pregnancy-related hypertensive disorders will be covered for the devices. Conditions like diabetes and COPD will no longer qualify.
Modern Healthcare:
UnitedHealth's Remote Patient Monitoring Decision Shocks Industry
The future of remote patient monitoring just got murky. Starting Jan. 1, UnitedHealth, part of UnitedHealth Group, only will cover the use of remote patient monitoring devices for its commercial and Medicare members who have heart failure or hypertensive disorders of pregnancy. The insurer said RPM for chronic obstructive pulmonary disease, diabetes and hypertension not related to pregnancy was not clinically proven and would not be covered. (Perna, 11/14)
More health industry developments —
Modern Healthcare:
Aetna Tones Down Medicare Advantage 'Downcoding' Policy
Aetna is dialing back a policy to “downcode” some hospital inpatient claims after facing pushback. The CVS Health subsidiary’s “level of severity inpatient payment policy” for its Medicare Advantage plans was due to take effect Saturday, but Aetna is pushing it back to Jan. 1 and reducing its scope, the insurer notified providers last Thursday. (Tepper, 11/14)
Los Angeles Times:
UC Nurses Cancel Strike Plans After Reaching Deal With University
A planned labor strike by University of California nurses has been called off after the university system and the nurses’ union reached a tentative deal on pay and benefits, both groups announced Sunday. The four-year deal, between UC and the California Nurses Assn., covers some 25,000 registered nurses working across 19 UC facilities. The two groups had been bargaining over a new contract since June. (Rector, 11/16)
WLRN Public Media:
South Florida Nurses Union Rallies In Hialeah For Better Pay, Patient Safety
Unionized nurses at three South Florida hospitals rallied outside Palmetto General Hospital in Hialeah on Friday morning for a new three-year contract, demanding more pay and better patient safety. The last contract expired Sept. 30 and current negotiations with Healthcare Services of America have since stalled, according to a statement from the nurses, who are members of the National Nurses Organizing Committee. (11/16)
Military.com:
Trust Betrayed At Fort Hood: The Army Doctor Accused Of Recording His Patients
On October 17, 2025, the U.S. Army suspended Major Blaine McGraw, a gynecologist at Carl R. Darnall Army Medical Center at Fort Hood, after a patient accused him of secretly recording her during a gynecological exam. According to a lawsuit filed in Bell County under the pseudonym “Jane Doe,” McGraw allegedly pretended to take a phone call, placed his smartphone in his breast pocket, and filmed the patient while performing a pelvic and breast exam without consent. The civil complaint claims investigators later discovered thousands of photos and videos of women on his phone, including imagery taken at prior assignments. (Fuller, 11/16)
