A system and method for providing hierarchical medical device control for automated patient management is presented. A processor is operatively coupled to a plurality of medical devices on a substantially continual basis to receive sensor data. A control strategy is assigned to the processor to specify actions to be taken by the medical devices to affect the attainment of a therapy goal. State is maintained, selected from the group comprising a history of changes to the control strategy and past sensor data received from the medical devices. Feedback is periodically received. The feedback includes new sensor data from the medical devices. The feedback and the state are analyzed against the actions specified in the control strategy. Control is provided to one or more medical device in response to an actionable change from the actions specified in the control strategy.