Medicare revises stance on at-home sleep tests
The Centers for Medicare and Medicaid Services has decided to reimburse for self-administered, take-at-home sleep studies to qualify patients for CPAP therapy. Private insurers likely will follow Medicare's lead.
The final national determination, announced March 13, comes with a string attached. Medicare will limit initial coverage of CPAP for OSA to 12 weeks to determine whether patients will respond to CPAP treatment. Patients will not receive long-term coverage if they do not show improvement within that three-month time period. Click here to read the decision memo.
The change has prompted cheers and boos among sleep professionals. Questions are swirling about the impact of the revisions on patient care, jobs, and future practice guidelines.
When blogger Pam Ryan, BS, RPSGT, first discussed Medicare's draft proposal, readers' comments reflected the complexity of the debate surrounding at-home sleep testing:
"For those of us who serve the rural population, we know that a large percentage of patients who must travel a great distance 'just to check my sleep' don't comply with physician recommendations for PSG. If we can at least get the most basic of sleep problems--OSA--diagnosed in the home, it will help us improve care for this demographic."- Tom, Kirksville MO
"There will be too many false negative and maybe some false positive test results. Then throw all the patients regardless of their other related medical conditions on CPAP?? Watch out! Trouble brewing! Also, abuse and over-utilization will lead to very strict guidelines a few years down the road. There goes another profession (sleep lab technologists) down the drain." - Andrew, Huntington NY
"This should allow growth and expansion of services to the patients that have not sought out diagnosis and treatment. There is plenty of room for controlled situations in Sleep Labs and to maximize business growth and service to all people who suffer from Sleep Apnea and the other Sleep Disorders in this realm of care." - Dan, Chicago Ill.
Time will tell how the revised reimbursement policy will affect the sleep industry. Tell us what you think: Are you worried about your job? How will the revisions impact patient care?