Recompete: CPAP and oxygen are lumped together


Today is National Sleep Apnea Awareness Day. Coincidentally, yesterday I assigned contributing editor John Andrews an article about the sleep/CPAP market. It's a story he does pretty much every year. I told to ask about audits, home sleep testing and compliance. I also suggested he ask about complementary products and whether the market is still growing. You know. The usual.

Then the unusual happened. Last night, CMS sent out its product categories for the Round 1 "recompete." In addition to some other, shall we euphemistically say, interesting choices, CMS has decided to create one overarching respiratory category, in which providers will have to bid both oxygen and CPAP. Yes, there are lots of providers who do both and do them well. There are also lots of providers who do one or the other, in particular, I think, I see this with providers who just focus on sleep and getting the patients compliant, not to mention, getting all the required documentation.

I just don't see the advantage, other than fewer providers for CMS to deal with, of creating this all-purpose category. Does CMS really want to force the transition of compliant Medicare patients from a familiar provider to a new one, and, in the case of new to the market providers, who don't have a proven track record getting patients compliant?

Theresa Flaherty