Many people have come to our blog looking for additional information regarding the recent decision not to provide Medicare coverage for unattended home sleep studies in the Local Coverage Determination that covers many parts of the country, including Wisconsin.
Here is the link you can follow to get the complete information that was released last week:
www.empiremedicare.com/nyorkpolicya/policy/l26428_lcd_notice_ngs.htm.
Mark Stoiber, President
3 comments
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February 25, 2008 at 1:38 pm
Dave J. (Scoop0901)
Medicare had the opportune time to approve in-home studies, with mandatory prerequisites, and failed to do so. This is such a great disservice to thousands in the U.S.
Many people in the U.S. live in rural areas, and I am not talking about towns and villages 10 or 20 miles away from a city with 50,000 population. I am talking about people who live in the middle of Kansas; people who live in the South-Central Illinois, folks who live in Central Pennsylvania; people who live in many areas of Idaho, Wyoming, North Dakota, and every other state.
The are countless people in need of sleep studies have a drive of more than three hours in order to get to a sleep lab, and possibly even further to consult with a qualified sleep specialist. This isn’t even taking into consideration the idea that the person may want to consult a board-certified sleep specialist.
In-home sleep studies would have, at the minimum, provided the opportunity for these people, among others, such as people who suffer a variety of disorders, among them medical and social disorders, that may prevent them from getting to a sleep lab. An in-home study would have afforded them the opportunity to have the sleep study interpreted by a qualified physician of their choosing.
This decision is just bad on so many counts. Next time, perhaps.
Cheers,
Dave J. (Scoop0901)
http://sleep.scoop0901.net/
http://blog.scoop0901.net/
****DISCLAIMER:****
I serve as the National Coordinator for Awake In America (http://www.AwakeInAmerica.org/), and we do have a Sleep Study Relief Program (http://www.awakeinamerica.org/DonateRelief/FAQ/SleepStudyProgramFAQ) that helps U.S. citizens without health insurance and/or without the financial means to obtain a sleep study via an in-home sleep study through a partnership with Sleep Solutions, Inc. (http://www.sleepsolutions.com/). We have a similar program set up for U.S. citizens in the same circumstances who are in need of xPAP equipment, the xPAP Donation and Relief Program (http://www.awakeinamerica.org/DonateRelief/FAQ/xPAPProgramFAQ).
February 27, 2008 at 3:39 pm
sleepwellandlive
Dave: You make some valid points, and we don’t want anybody to think that we are opposed to the overall concept of home testing. However, the proposal that was under consideration by CMS was, in our opinion, flawed in many ways and would have allowed for inadequate care and even fraud. The clinical studies that were used to support the proposal did not even include Medicare-age participants, who have many unique needs that home testing does not adequately provide for.
February 29, 2008 at 7:53 pm
Dave J. (Scoop0901)
Right, Mark, I understand and appreciate all that. As I said, Medicare had the opportunity — the chance — to craft things to serve the people, no matter their situation. A proposal under consideration is just that: a proposal.
The last time I checked, and perhaps things have changed, and if they did, please correct me. Medicare can change — or lay out — rules to its own standards. It does not have to accept the concepts or provisions in any proposal.
During its hearings, as well as inner workings, the proposal could have been modified, or Medicare could have established guidelines and set that down as the guiding dictates. Instead of doing something that could have helped many people, red tape, among other issues, fouled things up, sadly.