Committee Says No to In-Home Sleep Testing

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.