HHS appeals judge upholds revocation of a clinic/group practice that said it provides remote physiological monitoring and whose listed practice location was a flexible workspace
Published November 8, 2026 · Coverage November 1–7, 2026, Pacific · Lower priority
In decision CR7012, dated November 3, 2026, an administrative law judge affirmed CMS's revocation of the Medicare enrollment of MedStreamline LLC, a clinic/group practice. A CMS contractor's inspector found that the Houston address listed as the practice location belonged to a flexible workspace company, with no permanent signage or staff of the practice and none of its staff present at the visit. The company argued that it furnishes remote physiological monitoring with a remote workforce and is operational, but not at a specific location. The judge found the listed location had no staff or equipment of the practice and was not open to the public to provide healthcare services.
Background
The decision is from the Civil Remedies Division of the HHS Departmental Appeals Board. When it enrolled in Medicare in 2022 as a clinic/group practice, the company identified only a Houston address as its practice location and base of operations, and stated on its application that it did not store patient medical records electronically but stored them at a practice location or base of operations identified on the application form. In 2025 CMS, through a contractor, sent an inspector to confirm that the company was operational at its practice location.
Who this affects
Medicare-enrolled clinics and group practices that operate remotely or list a shared, virtual or flexible office as a practice location, including remote monitoring and telehealth vendors that hospitals contract with.
Why it matters
Inference: an enrollment record that lists a location where the practice does not actually operate can cost the enrollment, even when the practice says its services are furnished remotely. Hospitals and groups should check the practice locations on their own enrollment records and those of remote-service vendors billing under their own enrollment.
Recommended action
- Reconcile practice locations in the Provider Enrollment, Chain, and Ownership System (PECOS) with where staff and equipment actually are; remove or correct any listed location where the practice does not have the staff, equipment and public access needed to furnish health care services.
- Ask remote monitoring and telehealth vendors that bill Medicare under their own enrollment how their practice location is staffed.
Scope and timing
- Authority status
- Disposition
- Responsible owner
- Provider Enrollment; Compliance
- Other dates
- Enrolled 2022; site inspection 2025; decision dated 2026-11-03
Not established
Only the opening and the conclusion of the decision were read. The regulation cited for the revocation and any reenrollment bar were not read.
Sources
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