Wednesday, August 20, 2008

Local Coverage Determination for PAP Delayed

Recent studies have associated cardiovascular disease with obstructive sleep apnea. More than 12 million people are affected by the disorder, and many receive treatment each year with a continuous positive airway pressure (CPAP) machine, which the Centers for Medicare and Medicaid Services (CMS) acknowledges is safe and effective. Yet, the agency continues to provide conflicting policies on payment and testing related to these machines.

Most recently CMS provided new local coverage determinations (LCD) for PAP devices, requiring the new policies to go into effect on September 1, 2008 without offering a comment period and providing less than an ideal amount of time to implement the changes. The American Association for Homecare worked with industry stakeholders to delay the implementation date by sending a letter stating our concern for the quick implementation date and lack of input from the industry.

Yesterday, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for Jurisdictions A, B, C, and D announced a delay of the September 1, 2008 implementation date.

Full text of AAHomecare’s letter objecting to the September 1 deadline is available at www.aahomecare.org.

A revised policy will be published in the near future which we have requested provide at least 90 days before the implementation deadline.

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