RT Journal Article
SR Electronic
T1 Fifteen Patients Who Can Be Helped by Medicare
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP e200118
DO 10.1212/CPJ.0000000000200118
VO 13
IS 1
A1 Karin Gardner Johnson
A1 Marc Raphaelson
YR 2023
UL http://cp.neurology.org/content/13/1/e200118.abstract
AB Insurance coverage policies define the diagnostic criteria and adherence requirements for patients to qualify for initial and ongoing therapy with continuous positive airway pressure (CPAP) treatment, the most complete therapy for obstructive sleep apnea. Unfortunately, a number of patients who use CPAP and benefit from treatment fail to meet these requirements. We present 15 patients who fail to meet Centers for Medicare and Medicaid Services' (CMS) criteria, highlighting policies that do not support patient care. Finally, we review expert panel recommendations to improve CMS policies, and we suggest ways that physicians can better support CPAP access within the current regulatory restrictions.