A varied and growing group of sleep industry participants has formed a coalition to track sleep reimbursement trends and promote patient care through integrated care treatment models. 

“The Coalition for Effective Sleep Medicine was formed last year in response to shifting CPAP billing rules, sleep test reimbursement rates, and health reform proposals in Washington,” said Tim Miller, CEO of Dormir Inc and a member of the Coalition’s Executive Committee. “As an industry, we want to stay ahead of the curve in both quality of care protocols and reimbursement matters,” added Executive Committee member David Lewis, CEO of SleepMed Inc.

According to Executive Committee member Matt Mellott, president of MedBridge Healthcare, LLC, the Coalition came together to act jointly on four common goals: improving the quality of care for patients suffering from sleep-related disorders; advocating for better health outcomes through integrated sleep care delivery models; engaging with policy makers in Washington, DC to promote effective sleep medicine reimbursement methods; and adopting performance measures for tracking patient health improvements and reporting these results in support of integrated care models.

In 2008, several Coalition members were successful in educating the Centers for Medicare and Medicaid Services on the value of a coordinated approach to sleep medicine services. CMS referenced Coalition efforts in limiting the effect of the originally proposed “affiliation” rule.  Adoption of the rule as proposed would have limited the ability of sleep labs to provide CPAP treatment to their patients. 

Membership is open to all entities that are engaged in or promote an integrated care program for the detection and treatment of sleep disorders. 

“Integrated care models generally share a few basic characteristics,” said Executive Committee member Jack Miladin. “These include appropriate physician evaluation before ordering any diagnostic sleep test, performance of sleep tests consistent with existing accreditation standards, delivery and active follow-up of positive air pressure devices consistent with the patient’s overall long-term OSA disease care plan, and development of outcome measures to drive best practices for these integrated care methodologies.”

The Coalition has engaged the law firm of Greenberg Traurig, LLP, to represent the Coalition and advocate its goals and interests. Nancy Taylor of the firm’s Washington, DC office and Dan Brown of the firm’s Atlanta office work with the Coalition on these matters. 

Entities interested in joining should contact the Coalition through Katie Mahoney at Greenberg Traurig, LLP directly at [email protected] or (202) 331-3100.