Guidelines could level field

CPAP providers have mixed feelings about what the accreditation guidelines for sleep labs that are in-the-works could mean for them.

“We've been seeing this on the horizon and we are trying to work toward how we can compete with sleep labs,” said Jeff Knight, CEO of Premier Homecare in Louisville, Ky. “Most of these facilities have no idea of the labor component required to do this right. So, down the road, we think it may be a deterrent (for sleep labs).”

In November, the American Academy of Sleep Medicine announced it had established a task force to develop additional standards in response to new CMS guidelines for sleep therapy (See HME News, January 2009).

Accrediting sleep labs to provide CPAP could level the playing field, say some. Provider Sandy Fermoile shares space with a sleep lab, but in New York state, sleep labs don't dispense CPAP, he said.

“I don't know if it would be unfair,” said Fermoile, owner of Apnea Care in Buffalo, N.Y. “Whoever dispenses CPAP needs to do it correctly. If not, it hurts the whole industry.”

If sleep labs are planning to offer CPAP to Medicare patients, it's only fair that they be held to the same standards as providers, said provider Cary Nail. He says he already takes care of some patients who got their machines through sleep labs.

“They have no on-call support,” said Nail, president of Independent Med Services in Cullman, Ala. “We end up servicing those patients weekends and holidays.”

Providers like Todd Cressler question whether labs will even want to be in the CPAP business.

“They are busy enough as it is,” said Cressler, president and CEO of CressCare Medical in Harrisburg, Pa. “Why would I want to get into sleep labs? It's a totally different business model.”

But Jack Miladin, president of SleepCare Centers, says he would embrace new AASM accreditation guidelines. SleepCare operates dozens of sleep labs in several eastern states, and sells CPAP through its Continuing Care business.

“We do it to offer patients continuum of care,” said Miladin. “We've found that patients get lost. Their noncompliance rate was extremely high.”