Health Services, Policy, Payers

Debunked Episode 29: CMS GLP-1 Drug Pilot Program, RPM Strategy Raise Questions

At MedCity News’ inaugural Bullseye conference in Chicago, Debunked Podcast co-hosts Arundhati Parmar and Samir Batra discussed recent CMS actions and Mayo Clinic’s former research director, who has filed a complaint against the medical center over how it’s deploying AI.

Two developments at Centers for Medicare and Medicaid Services (CMS) captured the attention of Debunked Podcast co-hosts on the latest episode. Arundhati Parmar, editor-in-chief of MedCity News, noted that a new pilot Bridge program to help Medicare beneficiaries lose weight using popular GLP-1 drugs carries a hefty price tag of $741 million per month after the $50 monthly beneficiary copay, if all eligible recipients take part in the program.

The program seems to contradict concerns about Medicare solvency — a topic of much debate for decades on Capitol Hill.

Samir Batra, Managing Partner of Health Innovation Pitch, pointed out that employers are feeling the impacts of GLP-1 drug benefits and questioned how sustainable they are. GLP-1 drugs often cause uncomfortable side effects, leading some to stop taking them.

Meanwhile, the CMS 2027 Physician Fee Schedule proposed rule seeks to bar Medicare payment for thirdparty vendors supporting CMS remote patient monitoring programs. The move follows OIG reports that flagged widespread fraud in the space.

Unlike traditional remote patient monitoring, which tracks device-collected data like blood pressure or glucose levels, remote therapeutic monitoring covers self-reported, non-physiologic data — such as therapy adherence or pain levels, according to the recent MedCity News article.

Another topic of discussion on the podcast is former Mayo Clinic research director Traci Tamiko Eto’s complaint against the medical center, contending that its AI strategy undermines patient safety. The lawsuit also draws attention to what kind of guard rails are appropriate for AI implementation. Samir observed that the lawsuit raises questions on AI governance and who controls it at hospitals around the country. This is the kind of debate that is happening across industries but the ethical ramifications for healthcare and life sciences are particularly concerning.

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