In June 2012, New York payer MVP announced a new Sleep Study Benefit program that requires preauthorization for sleep testing and encourages the use of out of center sleep testing (OCST) in many patients. Recently, MVP announced a revision to its medical policy for OSA. Although the new policy includes some improvements, the AASM has continued to receive complaints from members about how MVP has implemented the policy, particularly regarding its restrictive contracting for OCST services. Qualified local providers of OCST have reported that they have been prohibited from joining the MVP network. As a result they have had to refer their patients to one of a few contracted providers or a national OCST service.
On behalf of its members, the AASM leadership has taken a strong stance with MVP. In a letter sent May 14, the AASM demanded that MVP take action to improve its OCST contracting, with an emphasis on qualified local providers.
