Fifteen Patients Who Can Be Helped by Medicare: Insurance Policy Changes in the Coverage of CPAP Therapy for Obstructive Sleep Apnea
Author Department
Neurology; Healthcare Quality; Medicine
Document Type
Article, Peer-reviewed
Publication Date
2-2023
Abstract
Insurance coverage policies define the diagnostic criteria and adherence requirements for patients to qualify for initial and ongoing therapy with continuous positive airway pressure (CPAP) treatment, the most complete therapy for obstructive sleep apnea. Unfortunately, a number of patients who use CPAP and benefit from treatment fail to meet these requirements. We present 15 patients who fail to meet Centers for Medicare and Medicaid Services' (CMS) criteria, highlighting policies that do not support patient care. Finally, we review expert panel recommendations to improve CMS policies, and we suggest ways that physicians can better support CPAP access within the current regulatory restrictions.
Recommended Citation
Johnson KG, Raphaelson M. Fifteen Patients Who Can Be Helped by Medicare: Insurance Policy Changes in the Coverage of CPAP Therapy for Obstructive Sleep Apnea. Neurol Clin Pract. 2023 Feb;13(1):e200118. doi: 10.1212/CPJ.0000000000200118. Epub 2023 Jan 20.
PMID
36865640