Comment on CMS-2026-2377-0002

Re: CMS-1848-P, Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule Dear Administrator: I am writing as a nurse who has worked in Remote Patient Monitoring for over a year, primarily during the night shift. I hope you will consider the very real impact RPM has on the patients who depend on it every day and the consequences patients may face if access to these services is reduced or eliminated. Working nights has given me a perspective on RPM that I believe is especially important. I talk to our patients during the hours when their doctor’s office is closed, when family members may be asleep, and when they may otherwise be alone trying to decide whether the symptoms they are experiencing are serious enough to seek help. I can say without hesitation that Remote Patient Monitoring has saved lives. I have personally witnessed situations where abnormal readings or a conversation with one of our nurses led to emergency intervention. We have called 911 for patients experiencing serious symptoms who may not have otherwise sought immediate care. We have stayed on the phone with frightened patients while emergency services were on their way. We have identified concerning changes, escalated them appropriately, and helped patients receive care when time truly mattered. These are not simply numbers on a screen. They are real people. Many of our patients are elderly, live alone, have multiple chronic conditions, or struggle to understand when a change in their health requires medical attention. For them, knowing that a nurse is available and paying attention provides an incredible sense of security. Our patients regularly tell us how thankful they are for our calls. They know our nurses. They trust us. Some of them depend on that interaction more than I think can ever be captured in a reimbursement code or a report. RPM also allows us to recognize problems before they become larger ones. A blood pressure reading, heart rate, blood glucose level, weight change, or new symptom can tell a much bigger story when someone is actually there to review it, speak with the patient, educate them, and determine what needs to happen next. As nurses, we also have the opportunity to educate patients repeatedly about their conditions, medications, proper monitoring techniques, symptoms to watch for, and when to seek help. Over time, we see patients become more engaged and knowledgeable about their own health. That is something I believe healthcare should be encouraging, not taking away. I understand that healthcare programs must demonstrate value and that costs matter. But I ask CMS to also consider the cost of what happens when this support is no longer there. What happens when the patient who lives alone has a dangerously abnormal reading at 11:00 p.m. and no one sees it? What happens when a patient dismisses worsening symptoms because they do not want to go to the emergency room? What happens when a preventable hospitalization occurs because an earlier warning sign was missed? After more than a year of doing this work, I don’t have to imagine those scenarios. I know how differently some of them could have ended if our nurses had not been there. I have heard the relief in a patient’s voice when they realize someone is there to help them. I have heard patients thank our nurses simply for checking on them. And I have seen situations where what began as a routine interaction ended with an emergency response that ultimately saved a patient’s life. Remote Patient Monitoring is not just technology. The device is only one piece of it. Behind that reading is a patient, and behind the monitoring is a healthcare professional who can recognize when something is wrong and take action. Please do not take that connection away from the patients who have come to depend on it. I respectfully ask CMS to preserve meaningful access to Remote Patient Monitoring and consider the experiences of the patients, nurses, caregivers, and providers who see its impact firsthand. For some patients, RPM may be a convenience. For others, it may be the reason someone realizes they need help in time.