ARLINGTON, Va.--Last week, the American Association for Homecare submitted comments to CMS on the national coverage determination for CPAP therapy.

The current NCD dictates that OSA patients needing CPAP must be diagnosed through a sleep lab polysomnography study in order for Medicare to cover the cost of treatment. But in response to a request from the American Academy of Otolaryngology-Head and Neck Surgery to consider including multi-channel home sleep testing devices as an option, CMS reopened the NCD for reconsideration. (See HomeCare Monday, March 26.)

In its comments, AAHomecare said that "early identification and treatment of sleep disorders is essential for the safe and effective care and management of Medicare beneficiaries. The clinical and economic benefits of logical, practical, and clinically sound sleep testing and treatment will become evident as the Medicare program continues to evolve. The long-term value of such a practical and clinically important benefit cannot be understated."

The association said it supports a revision to the current NCD that would:

--Permit the use of portable, multi-channel sleep testing in the home as a diagnostic alternative to facility-based polysomnography for the evaluation of patients with likely OSA.

--Revise the criteria for determining the Apnea-Hypopnea Index (AHI) to be equal to the average number of episodes of apnea and hypopnea per hour and be based on a minimum of two hours of sleep or less, if the actual number of AHI episodes recorded is 30 or more in less than two hours, recorded by polysomnography using actual recorded hours of sleep.

--Develop a policy for the use and coverage of positive airway pressure therapy for a select group of severe patients not yet evaluated through formal sleep testing.