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Medicare Approves In Home Sleep Apnea Testing

Posted Sep 14 2008 12:18am

The Centers for Medicare and Medicaid services (CMS) have, as of March 2008, approved at-home sleep testing for obstructive sleep apnea (OSA). Previous policy had mandated that suspected sleep apnea sufferers must undergo facility-based polysomnography. The new policy allows continuous positive airway pressure (CPAP) treatment for Medicare patients who are diagnosed via unattended home monitoring devices. It is expected that this decision will prompt increased coverage from insurance companies around the country, because many providers follow the lead of CMS in determining their medical policies.

We are very excited about the change in coverage as it demonstrates that our portable sleep testing program, which we have successfully offered for the past 14 years, is a viable and effective alternative to sleep lab testing. This policy change will almost certainly allow us to provide services for many sleep apnea sufferers who previously could not avail themselves of our services, because they were not covered by their insurance providers.

While coverage has been approved, we are still waiting to hear the specific date that the policy will actually go into effect. It may be different in varying areas of California and across the country. In the meantime, several insurance providers have begun to change their coverage to align with Medicare and Medicaid

We were quite happy to learn that upon hearing of the approval, Aetna immediately revised their medical policy to mirror Medicare’s. We expect other plans that follow Medicare, such as Triwest, will also adopt this policy. SleepQuest will continue to work closely with Medicare and other insurance companies to ensure that coverage expands, making treatment more available and affordable to more patients. We have also been in contact with other providers such as Blue Cross of California, who currently allow home sleep testing but impose numerous coverage restrictions, in order to see how they intend to revise their policies.

An estimated 30 million Americans suffer from some form of sleep apnea.

SleepQuest anticipates significant growth and is planning for expansion. A new office conveniently located in San Francisco is scheduled to open by July of this year, and it will service current and new patients.

For almost 15 years, SleepQuest has been a leader in at-home testing and treatment of sleep apnea. We anticipate that as coverage continues expanding, we will be able to focus on getting more patients tested quickly and comfortably in the home environment.

We look forward to helping even more OSA sufferers with our comprehensive approach to wellness and vitality.

–Robert Koenigsberg

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