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CMS-1403-FC
facility in which a technologist supervises the recording
during sleep time and has the ability to intervene if
needed.
The NCD represents a significant expansion of coverage
and facilitates the new participation of new entities that
had not previously been involved in the provision of this
benefit. This also allows testing to occur in patient
homes, which are not regulated as health care facilities.
For these and additional reasons we describe below, we
believe that the diagnosis of OSA for coverage of CPAP
merits proactive and ongoing oversight by CMS. Therefore,
we intend to closely monitor this benefit.
During the NCD public comment period, we received many
comments expressing concern that financial incentives could
lead to abusive testing practices that may harm Medicare
beneficiaries and the Medicare program. Though these
concerns were largely focused on vulnerability that might
accompany the entry of new types of entities into the sleep
test business following a broad expansion of coverage, some
commenters suggested that vulnerabilities would be found in
sleep test facilities. Therefore, in the CY 2009 PFS
proposed rule, we proposed to prohibit the provider of a
qualifying sleep test—both PSG and HST—from also being the
supplier of the CPAP device. Our use of the term provider
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