AAHomecare Comments on CPAP NCD

ARLINGTON, Va.–Last week, the American Association for Homecare
submitted comments to CMS on the national coverage determination
for CPAP therapy.

The current NCD dictates that OSA patients needing CPAP must be
diagnosed through a sleep lab polysomnography study in order for
Medicare to cover the cost of treatment. But in response to a
request from the American Academy of Otolaryngology-Head and Neck
Surgery to consider including multi-channel home sleep testing
devices as an option, CMS reopened the NCD for reconsideration.
(See HomeCare Monday, March 26.)

In its comments, AAHomecare said 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 association said it supports a revision to the current NCD
that would:

–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.