We have just received word from the American Academy of Sleep Medicine that National Government Services, an agent contracted by the Centers for Medicare & Medicaid Services (CMS), has released its Local Coverage Determination (LCD) for polysomnography and sleep studies (L26428). The LCD affects the following primary geographic jurisdictions: American Samoa, California, Connecticut, Delaware, Guam, Hawaii, Kentucky, Illinois, Indiana, Maine, Marina Islands, Massachusetts, Michigan, Nevada New Hampshire, New Jersey, New York (with the exception of Queens County), Ohio, Vermont, Virginia, West Virginia, and Wisconsin.

Effective April 1, 2008: “For a study to be reported as a polysomnogram, sleep must be recorded and staged and must be attended. Sleep studies should be performed in a hospital, sleep laboratory or by an Independent Diagnostic Testing Facility that is supervised by a physician (MD/DO) trained in analyzing and interpreting the recordings and should be attended by a trained technologist. Sleep studies performed in the home are not covered.”

This is outstanding news for those of us who have stated from the beginning that unattended at home sleep studies for Medicare beneficiaries are not in their best interest. It is a clear statement that ensuring quality of care for our Greatest Generation outweighs expediency.

Mark Stoiber, President