Post Reply 
[News] OIG Urges CMS to Revise CPAP Replacement Schedules
Author Message
ApneaNews Offline
Apnea News Correspondent
Advisory Members

Posts: 170
Joined: Feb 2012

Machine: IBM Selectric II
Mask Type: Full face mask
Mask Make & Model: 3M N95 (it gets dusty in the newsroom)
Humidifier: Sears Kenmore (circa 1979)
CPAP Pressure: 3200 psi
CPAP Software: Other Software

Other Comments: I report, therefore I am.

Sex: Undisclosed
Location: In the newsroom (where else?)

Post: #1
OIG Urges CMS to Revise CPAP Replacement Schedules
OIG Urges CMS to Revise CPAP Replacement Schedules

Following the results of a recent study, the Office of Inspector General (OIG) has urged the US Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) to review and revise the CPAP supply replacement schedule in a report published today.

The study, prompted by a 2012 finding that CMS beneficiaries may have received more CPAP supplies than medically necessary, was conducted to assess waste within health care services.

The OIG reviewed CPAP replacement supply schedules in effect as of January 1, 2012 from 50 fee-for-service State Medicaid programs and from four fee-for-service Federal Employees Health Benefits plans. They compared the replacement schedules for 15 types of CPAP supplies with Medicare’s schedules against recommended replacement schedules from five sleep disorder clinicians and four manufacturers.

The OIG concluded that 39% of frequencies were less than those under Medicare, 51% equaled those under Medicare, and 10% of frequencies exceeded those under Medicare.

Sleep medicine clinicians stress the importance of proper mask fit, but research suggests that once fit is established, necessary replacement of masks is less frequent than Medicare allows, according to the report. Also, manufacturers recommended specific replacement frequencies for only a few types of supplies on an as-needed basis and potentially less frequently than under Medicare’s replacement schedule.

CMS did not concur with the OIG’s suggestion to review CPAP supply replacement schedules and make efforts to revise the national and local coverage determination, stating that "failure to consider noncompliance or the potential impact of supplier fraud or abuse may bias the estimate of a clinically appropriate refill rate."


Fair use from:
http://www.sleepreviewmag.com/all-news/1...-schedules

The above post may contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. The material available is intended to advance the understanding of Sleep Apnea treatment and to advance the educational level of Sleep Apnea patients with regard to their health. Sometimes included is the full text of articles and documents rather than a simple link because outside links frequently "go bad" or change over time. This constitutes a "fair use" of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this post is distributed without fee or payment of any kind for research and educational purposes. If you wish to use copyrighted material from this post for purposes of your own that go beyond "fair use", you must obtain permission from the copyright owner.
07-04-2013 06:42 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: OIG Urges CMS to Revise CPAP Replacement Schedules
What? Is it overspending or not? And what the heck did that last sentence mean?

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
07-04-2013 07:41 PM
Find all posts by this user Post Reply Quote this message in a reply
JJJ Offline

Advisory Members

Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #3
RE: OIG Urges CMS to Revise CPAP Replacement Schedules
(07-04-2013 07:41 PM)PaulaO2 Wrote:  What? Is it overspending or not? And what the heck did that last sentence mean?

Maybe there's a US federal employee here who can translate. Smile
07-04-2013 09:54 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PollCat Offline
Apnea Board Polling Administrator
Monitors

Posts: 1,576
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: H5i Cleanable with ClimateLine
CPAP Pressure: 10 - 18
CPAP Software: SleepyHead

Other Comments: CPAP-ing since 1995; Type 2 Diabetes; Chronic Asthma; Gout

Sex: Male
Location: Westfield, IN

Post: #4
RE: OIG Urges CMS to Revise CPAP Replacement Schedules
Having worked for Uncle Sam for more than 42 years I'd love to translate this. Basically CMS is contending that HHS-OIG did not take into consideration certain aspects of the process that CMS considers important. Or in other words, CMS is blowing smoke so that they do not have to comply with the OIG recommendations. (Having worked for 17 years as an auditor for USDA-OIG, I saw this type of response from audited offices a lot. Instead of taking corrective measures to fix the problem, the audited office is rebutting the findings based on the way the review was conducted).
07-04-2013 11:23 PM
Find all posts by this user Post Reply Quote this message in a reply
FS560 Offline

Members

Posts: 11
Joined: Jul 2013

Machine: S9 autoset
Mask Type: Full face mask
Mask Make & Model: fitlife
Humidifier: h5i
CPAP Pressure: 10-19
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Richmond, VA

Post: #5
RE: OIG Urges CMS to Revise CPAP Replacement Schedules
The fitlife mask that I use may last forever. the new one works no better than the old one. Medicare will replace the mask every three months but the headgear only every six months. Because of high pressure and resultant very tight mask, headgear will not last six months without changing geometry as I continually tighten it.

Jim Quarles
hosehead
Illegitimus non Carborundum
07-28-2013 10:01 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
robertbuckley Offline

Preferred Members

Posts: 99
Joined: Mar 2013

Machine: Resprionics BiPAP Auto SV Advanced
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F-10 Full Face
Humidifier: Resprionics System One
CPAP Pressure: EEP 15; PS 4 - 10
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: New York, NY

Post: #6
RE: OIG Urges CMS to Revise CPAP Replacement Schedules
The system (insurance and medicare) is broken and not responsive to individual needs and requirements. Do I need a new mask every 6 months or a hose every 3? NO. Do I need more than 2 disposable filters a month - YES (in fact I change the intake every week and use an inline outake every 2 - so that makes 6 filters a month, and they do not differentiate between the 2 types). Do I suspect that I need the foam intake filter changed more often than every 6 months (based on what I see on the disposables) - YES (and I do wash it every week). But, every locale and person is treated in the same way with the "standards" set by "somebody" who knows "best". I sometimes wonder if the costs of fraud prevention and standards setting exceeds what they save.
07-31-2013 04:18 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Headgear replacement ? worthog 3 189 11-27-2016 02:03 AM
Last Post: GP49
  [CPAP] Whining siren noise and bearing replacement/repair clintga 23 6,325 11-22-2016 02:52 PM
Last Post: Sleeprider
Money Replacement Tming MikeV99 1 253 07-07-2016 11:21 PM
Last Post: PoolQ
  Will DME Supplier provide different Mask as Replacement Supplies photosmike 8 584 06-09-2016 03:24 PM
Last Post: AndyB
  Replacement supplies from Medicare galenaforest 4 666 05-25-2016 11:34 AM
Last Post: galenaforest
  Can Testosterone Replacement Make OSA Worse Adoniscmj 14 940 05-01-2016 01:18 PM
Last Post: Sleeprider
  Replacement machine hassles DCwom 20 1,686 04-08-2016 02:57 PM
Last Post: Shastzi

Forum Jump:

Who's Online (Complete List)