OSA monitors get “no” from CMS in US (US/World)
January 2005 - Medicare officials have tentatively turned down a request that the health plan pay for portable machines designed to measure obstructive sleep apnoea (OSA) in the home.
The health plan currently pays for sleep lab studies or polysomnograms conducted in hospitals or freestanding clinics that monitor sleep stages, respiratory effort, oxygen saturation, heart rate, body position and limb movements. In April 2004, Dr Terence Davidson of the University of California San Diego, School of Medicine, asked Medicare to cover the use of portable multi-channel home sleep testing devices as an alternative to facility-based sleep labs.
Professional groups generally supported extending coverage to the portable devices, arguing it was cost effective and would expand access because of long waiting lists for a sleep lab evaluation in some parts of the US. But after analysing the data, the Centers for Medicare & Medicaid Services (CMS) concluded there was insufficient proof that the portable devices are as effective as sleep labs in diagnosing OSA.
At the same time, the agency also raised questions about the sleep labs, saying they also warrant further study. Although sleep labs are considered the gold standard for the diagnosis of sleep disorders, there is insufficient clinical evidence available to assess the validity of laboratory based polysomnography in diagnosing OSA in adults, CMS noted.
Moreover, physicians might achieve the same outcomes if they try treating people at risk of OSA with a continuous positive airway pressure therapy machine that keeps their airways open while sleeping without initial diagnosis in a sleep lab, it added.
Several companies make portable devices, including Viometrics, Oxford BioSignals and Snap Laboratories.
CMS will now seek public comment on its proposed coverage decision over the next 30 days before finalising its coverage decision. |
