Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Thursday, February 4, 2010

New Medicare Guidelines for CPAP

The new medicare guidelines for CPAP coverage state that patients must have compliance of at least 4 hours a night and wear CPAP 70% of the time for a 30 consequtive day period.

These guidelines reflect how little CPAP is uded. Even with these looose standards medicare expects to save substantial dollars. $-5 hours is the average amount of time patients wear CPAP. 7-71/2 hours of nightly use is recommended. Ideally CPAP should be worn nightly.

If medicare required 90% usage or 6 hours of wear almost no one would qualify for coverage. I think the new standard for coverage is appropriate because it will save medicare the cost of buyiny CPAP machines that are not used (wasted taxpayer money)and patients who wear CPAP 4 hours nightly (average use for all patients) will have coverage. Medicare will cover CPAP based on low expectations of use that history and published studies have shown to be the case.

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posted by Dr Shapira at 8:43 AM