Medicare Reimbursement on CPAP Supplies - Could Less Be More?

If you haven't heard, Medicare and private insurersrather can tweak our therapy if something is not
are putting the screws to the Durable Medicalworking, and quantify the results of the tweak.
Equipment companies (DMEs) that provide our CPAPNow the reason the dumb machines were put out
supplies in an effort to cut costs, much to thethere in the first place was because the DMEs could
chagrin of the DME providers. One aspect of theget away with it. Not any longer. Insurers are saying
cost-cutting is to deny reimbursement to DMEs andyou have to give out data capable machines,
other providers that cannot show that their patientsbecause there is no other way you can prove to us
are complying with CPAP treatment. While at firstthat the machines are being used and unless we
blush, this might seem like an adverse developmenthave that proof, we're not going to reimburse you
for us patients, the problem for us might be that thefor it. And look what the result is: chances are slim
insurers didn't do this sooner, and that they haven'tthat any Sleep Apnea newbie is being prescribed a
yet gone far enough.machine that doesn't at least have some basic data
My thinking is this: for too long, DMEs could get awaycapability.
with giving out to patients the most basic, leastBut let's not rest on our laurels. That's a step in the
effective and "dumbest" machines out there. Theseright direction, but just a baby step. What we are
are the machines that cost the DMEs the least (andreally after with data monitoring isn't just knowing
result in the greatest profit margin), but which alsothat the machine is on, but knowing that it is being
reduce the likelihood of us getting well with Sleepeffective. So I would advocate that the insurers
Apnea. With no feedback given to the patient onmake the DMEs reimbursement conditioned on
how the patient is doing, the patient quickly kicksefficacy data, and not just compliance data. My
aside the treatment altogether when something goesguess is after a little while with this regime in place,
wrong, because there is no obvious path to fix thewe'll see a big move forward in patient compliance
problem. As we know, data-capable machines providerates, and in innovative technology designed to
this feedback so that we are not "flying blind," butimprove compliance.