The Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would, "prohibit payment to the supplier of the CPAP device when such supplier, or its affiliate, is directly or indirectly the provider of the sleep test that is used to diagnose a Medicare beneficiary with OSA." As such, CMS is "proposing to revise the DMEPOS supplier enrollment safeguards set forth at $424.57 to protect the Medicare program and its beneficiaries from fraudulent or abusive practices that may be related to CPAP devices." In the notice CMS also proposes new definitions for "sleep test" and "CPAP device" and the addition of new language that would establish specific payment prohibition as described in the first sentence.
Read an excerpted version of the notice online: www.aasm.org/resources/pdf/cms1403.pdf.
There is an open comment period on this proposed rule, and instructions on how to submit a comment follows. Refer to file code CMS-1403-P and include the caption "OTHER ISSUES-SLEEP TESTS" at the beginning of your comment. Comments must be submitted by Friday, August 29, 2008.
1. Electronic comments may be submitted via www.regulations.gov/search/index.jsp. Follow the instructions for "Comment or Submission" and enter the file code CMS-1403-P.
2. Comments may be sent by mail to the following address:
Department of Health and Human Services
Attn: CMS-1403-P
P.O. Box 8013
Baltimore, MD 21244-8013
3. Comments may be sent by overnight mail to the following address:
Department of Health and Human Services
Attn: CMS-1403-P
Mail Stop C4-26-05
7500 Security Blvd.
Baltimore, MD 21244-1850
The American Academy of Sleep Medicine will keep members abreast of developments regarding this policy.
