AASM Advocacy Efforts to Ensure Sleep Services are Included in State Exchanges
The AASM continues to work to ensure that sleep services are covered in every state exchange. Since 2012, the AASM has submitted letters to every state insurance department, medical society and exchange, in addition to the Department of Health and Human Services (HHS).
AASM staff advocates have spoken to officials from the Center for Consumer Information and Insurance Oversight (CCIIO), a department within CMS charged with helping implement many provisions of the Affordable Care Act (ACA). CCIIO confirmed that our strategy was a correct course of action and that we have so far gone through the correct channels. CCIIO also recommended that we contact the private payers who will be offering the plans within each exchange.
Infographic: AASM Advocacy Efforts
On April 29, 2013, the AASM followed through with this recommendation by submitting more than 350 letters to senior executives at leading corporate and state health insurance companies. Each of these companies is responsible for medical services, government programs, provider services or insurance products. The letters informed them of how sleep services should be covered in the EHBs and highlighted the following points:
- Millions of individuals that will be entering the health care system through the ACA will need of sleep services;
- Sleep services are not specified in the law; and
- Sleep services should be recognized and that these procedures are medically necessary.
A second round of letters was sent out during the first week of June to the companies that had not responded to the April letter. Responses from the June mailing include: the corporate offices of Humana, United Health Care and Kaiser.
Responses from Payers
As of September 2013, the AASM has received a total of 90 responses from insurance companies, 61 of which confirm that sleep services will be covered in their state exchange products. The AASM has not received any responses indicating that sleep services will not be covered.
Members can view a few of the responses AASM has received. The information includes: senior executives name and title, date letter was submitted, date of response, follow-up and additional comments. The AASM is currently reviewing the Exchange policies to see how they correspond with AASM Accreditation.