A bipartisan group of House lawmakers is urging the Trump administration to reconsider a rule that would ban third parties from remote health monitoring reimbursements under Medicare, arguing it would cripple health systems in rural communities.

In a letter to CMS Administrator Mehmet Oz dated Oct. 2, 32 lawmakers pushed back on the proposed rule, which is intended to root out fraud and would require patient monitoring technology to be overseen solely by in-house clinical staff rather than third-party vendors.

If enacted, this rule would “reduce access to care for millions” of seniors who receive Medicare, with “particularly severe consequences for rural communities and patients served by small and independent practices and hospitals,” according to the letter led by Rep. David Kustoff (R-Tenn.) and Rep. Troy Balderson (R-Ohio).

The letter argues remote tools are crucial for improving care in rural areas by identifying worsening conditions, monitoring health metrics, and allowing for intervention before a patient needs emergency care. Most hospitals, which already face short staffing, don’t have the resources to run these tools themselves, the lawmakers argue, leading them to rely on third parties to fill in gaps.

Long travel distances, transportation barriers, and clinician shortages, among other factors, can make access to medical care difficult for seniors in rural communities, lawmakers said.

The proposed policy comes as lawmakers work to bolster access to remote patient tools, including expanding reimbursements for them during the pandemic and recently advancing a House bill that would strengthen the quality of the tools and establish a national floor for reimbursement.

Spending in Medicare on remote patient monitoring has skyrocketed since 2019, growing to $500 million in 2024, which some internal HHS watchdogs say is due in part to fraud. The Trump administration has made efforts to crack down on the fraud in recent years.

While lawmakers said in the letter that they “deeply share CMS’s interest in rooting out waste, fraud, and abuse in all forms,” they added it is “imperative to distinguish fraudulent arrangements and inappropriate behavior from legitimate, clinically necessary care.”Over 1 million Medicare enrollees used a telehealth service in 2025, a CMS report states, with representatives arguing in the letter that reducing access to these programs could increase hospitalizations and raise care costs by more than $1,300 per patient. The letter follows concerns raised by hospitals, doctors, and telehealth firms that urged the Trump administration to hold off on a proposal last month.

While CMS acknowledges the importance of tech care to improve access, Medicare “must have appropriate safeguards to ensure that services are medically necessary,” a spokesperson for CMS said, adding the policies are intended to “strengthen accountability by reinforcing the role of the billing practitioner and supporting appropriate patient-provider relationships.”

To contact the editors responsible for this story: Brandon Conradis at ; Kathy Larsen at