Providers prepare for sleep test fight

Saturday, May 31, 2008

LUBBOCK, Texas--CMS gave its blessing to home sleep tests in March, but HME providers should expect a battle when it comes to shaping the final policies.

“You’ve got a set of players positioning themselves to fight anyone else being involved in testing,” said Kelly Riley, director of The MED Group’s National Respiratory Network.

Those players include sleep labs, as well as the American Academy of Sleep Medicine (AASM), which has said it supports home sleep tests but also says all sleep testing should be done under the oversight of a sleep medicine specialist and through accredited sleep centers (See HME News, March).

AASM recently communicated to its members that it will continue to make “portable monitoring” a priority, including communication with Congress.

“We think they are going to recommend that testing still take place within a sleep lab,” said Riley.

The delay in the final LCDs offers providers an opportunity to make themselves heard, said Riley, during an e-conference last month.

“We need to speak up and get letters out to the medical directors,” she said. “We need to challenge them to comply with the intent of the national coverage determination for easier and more rapid access to diagnosis and treatment.”

The Respiratory Network has created template letters and supplied a directory of state medical directors for providers to use and encourages providers to make in-person visits as well.

One provider who spoke at last week’s e-conference has taken “an aggressive approach.”

“Are we going to sit back and be passive and let the AASM and the sleep labs sway the opinion on LCDs?” he asked.

Providers should establish a foundation so when the final LCDs are released, they will be ready to jump in, said Riley.

“Get the word out and establish yourself as the go-to person in this arena,” she said.