An announcement from NHIC Corp, a CMS contractor, stated earlier this week that provisions from the Local Coverage Determination (LCD) on Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea are being delayed. The announcement was followed by an identical release from Cigna and National Government Services. Noridian is expected to follow suit.
"In July, the DME MACs published a Local Coverage Determination (LCD) on Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea. Some criteria in that policy were to take effect for dates of service on or after September 1," the announcement stated. "All criteria with a September 1, 2008 implementation date are being delayed."
Commenting on the LCDs, Christian Kiely, marketing manager, Fisher & Paykel Healthcare Inc, said, "The recent DME MAC PAP policies placed an enormous burden on homecare providers in terms of pre-study and adherence to therapy documentation. With today’s announcement of the delays in the implementation of the policies, we are hopeful that the scope of the policies will be revised to more closely resemble the spirit of the National Coverage Determination. There were several items in the LCDs that were not previously addressed via a public comment process."
Landon Pendleton, director of product development, Instant Diagnostic Systems Inc, agrees that lack of a public comment process is part of the reason for the delay. “I would think they would either scale back some of the newly introduced criteria and restrictions and/or open the LCD’s up for comment.” Pendleton also attributed the delay to other factors, stating, “We feel the delay is in response to the massive amount of pushback on several controversial restrictions and new pieces in the latest iteration of the PAP LCD relating to HST and the new compliance criteria.”
According to the announcement, "A revised LCD will be published in the near future and will include a new effective date for those criteria."
LCDs Bring Clarity to Home Testing Policy