Policy Watch
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UnitedHealthcare Tried to Cancel Remote Monitoring for Most Medicare Patients. Here’s Why It Matters.
In late 2025, UnitedHealthcare announced it would stop covering remote patient monitoring for nearly all conditions starting January 1, 2026 — including chronic hypertension, diabetes, and COPD — affecting millions of Medicare Advantage members. The policy would have limited RPM coverage to only heart failure and pregnancy hypertension patients. The backlash was immediate. Two weeks…
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CMS WISeR Model Uses AI-Assisted Review for Selected Medicare Prior Authorization Requests
Since January 1, 2026, Medicare patients in six states have had their care requests evaluated by an AI system called WISeR — the Wasteful and Inappropriate Service Reduction model, a CMS pilot active in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. The program screens Medicare prior authorization requests for services deemed “low-value,” and it…
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Telehealth Is Extended Again. But ‘Extended’ Is Not the Same as ‘Permanent.’
Medicare telehealth survived another near-death experience in early 2026. When a 42-day government shutdown caused COVID-era telehealth waivers to briefly lapse, research from Brown University documented a 24% drop in telemedicine visits in just the first two weeks. Congress responded with a retroactive two-year extension through December 31, 2027, passed as part of a February…