Medicare Announces Proposed Policy For Continuous Positive Airway Pressure (Cpap) Therapy For Obstructive Sleep Apnea (OSA), USA

The Center for Medicare & Medicaid Services (CMS) has proposed to Medicare for the continuous reporting positive airway pressure (CPAP) equipment to beneficiaries who have been diagnosed with obstructive sleep apnea (OSA) as a result of a Type II, III or IV home to sleep Test (HST).


OSA is a condition in the period of temporary suspension of breathing (apnea) during sleep. In most cases, OSA is diagnosed by the number of sleep disorders, during a certain period. Up to 4 million Medicare beneficiaries suffer from OSA.


CPAP devices provide air pressure through a mask to the breathing during sleep passages open. Medicare current political reporting CPAP provides only for the beneficiaries, the OSA diagnosed about polysomnographischen (PSG) in a sleep laboratory setting.


"Our policy proposed that the coverage of the continuous positive airway pressure provides more options for Medicare beneficiaries and their doctors," said acting CMS Administrator Kerry Weems.


CMS also proposes to expand coverage of the CPAP under the cover with Evidence Development (CED) process for beneficiaries who are diagnosed with OSA either on a clinical evaluation alone, or on another as a diagnostic test PSG or Type II, III or IV HST. The CED under participation in a study is not required. Such investigations should be the standards in CMS 'Clinical Trial Policy.


Moreover, CMS is proposing to the current requirements for a period of at least two hours of uninterrupted sleep collected during tests, recognizing that some patients with very severe OSA is not in the able to fulfill this requirement. The proposed policy considers a positive test if the total number of sleep disorders reached over two hours, regardless of whether two hours of uninterrupted sleep occurred.


Finally, CMS proposes that all initial coverage of CPAP for OSA is limited to twelve weeks, to determine whether the recipient is on the CPAP treatment.


"The proposed policy encourages and supports the development of additional evidence to determine other means of diagnosing obstructive sleep apnea," said Weems. "CMS will continue its commitment to the ongoing monitoring of the utilization of continuous positive airway pressure devices."




CMS plans for a final determination of the national reporting in March 2008. CMS invites public comments on the proposed decision, which may be found here. instructions for the submission of comments can be found here.

http://www.cms.hhs.gov