The American Association for Homecare has issued comments in response to the Center for Medicare & Medicaid Services’ (CMS) review of the national coverage determination (NCD) for CPAP therapy.
AAHomecare stated that “early identification and treatment of sleep disorders is essential for the safe and effective care and management of Medicare beneficiaries. The clinical and economic benefits of logical, practical and clinically sound sleep testing and treatment will become evident as the Medicare program continues to evolve. The long-term value of such a practical and clinically important benefit cannot be understated.”
The organization also stated that it supports a revision to the current NCD that will:
- Permit the use of portable, multi-channel sleep testing in the home as a diagnostic alternative to facility-based polysomnography for the evaluation of patients with likely OSA.
- Revise the criteria for determining the Apnea-Hypopnea Index (AHI) to be equal to the average number of episodes of apnea and hypopnea per hour and be based on a minimum of two hours of sleep or less, if the actual number of AHI episodes recorded is 30 or more in less than two hours, recorded by polysomnography using actual recorded hours of sleep.
- Develop a policy for the use and coverage of positive airway pressure therapy for a select group of severe patients not yet evaluated through formal sleep testing.
Currently, the NCD states that only polysomnography performed in a facility-based sleep study laboratory may be used to identify patients with OSA who require CPAP. In response to a formal request from the American Academy of Otolaryngology-Head and Neck Surgery to remove the requirement for facility-based polysomnography, CMS reopened the NCD on CPAP therapy for OSA for reconsideration.
To read the complete letter with comments, visit www.aahomecare.org.