The current practice model of care for Medicare patients with obstructive sleep apnea is fragmented. The federal Stark Law prohibits sleep medicine physicians from providing therapeutic DME to Medicare patients for the treatment of OSA. Instead of receiving PAP equipment and personalized treatment support from their physician and medical team, patients have to interact with an outside DME company. This adds an unnecessary layer of complexity to the treatment plan for Medicare patients, who often are overburdened with medical needs and decisions.
Currently one of the AASM’s primary initiatives is to advocate for a Stark Law exception that will allow board certified sleep medicine physicians to provide long-term care for Medicare patients with sleep apnea.
The AASM’s position is that board certified sleep medicine physicians and their team are uniquely qualified to provide the continuity of care that will enable Medicare patients with OSA to achieve treatment success and maintain long-term adherence to therapy.
The ACA requires that states establish an insurance exchange by January 1, 2014. Although it is difficult to determine how exchanges will affect sleep medicine specifically, it is important that members have an understanding of how exchanges will be operated.