Baltimore
The Medicare Coverage Advisory Committee (MCAC) has made a
preliminary decision not to expand program coverage for in-home
sleep testing.
Current national coverage policy requires that only a
polysomnography conducted in a facility-based sleep study lab be
used to identify patients with obstructive sleep apnea (OSA)
requiring CPAP (continuous positive airway pressure) devices. But
last year the agency received a request to include the use of
portable multi-channel home sleep testing devices and, since, has
taken the discussion through CMS' National Coverage Determination
process.
On Jan. 7, the agency posted the preliminary decision to keep
the current policy in place, stating, “the evidence is not
adequate to conclude that the use of unattended portable
multi-channel sleep testing … is reasonable and necessary in
the diagnosis of OSA, and these tests will remain non-covered for
this purpose.”
During recent months, stakeholders in favor of in-home sleep
tests have said such coverage would make it easier for patients to
test for OSA, in turn easing treatment efforts nationwide.
Those against the coverage say an in-home test doesn't replace a
lab-based sleep study conducted under the auspices of a
credentialed sleep clinician or physician and has the potential for
abuse and misdiagnoses.
