How does CPAP usage get reported to Medicare?

Goofproof wrote:The NSA...

LOL


As for Medicare, compliance is only required for the first CPAP machine. Thereafter the DME is supposed to get annual medical notes from the treating doctor to the effect of "the patient is still using and benefitting from CPAP therapy". That's it. Anything beyond that is a personal policy or misinterpretion from your doctor or DME.

FYI - When you receive your 1st machine before joining Medicare the only requirement for continued treatment is to verify the original sleep study report was Medicare compliant. I.e. The DME sends a request to your doc and then sticks the report in their files in case Medicare ever audits them.

LSAT wrote:
I have been on Medicare/Medicare Advantage for 12 years. This is my second Medicare paid machine. No one ever asked me for compliance data.

Expect a bill for $479,312.34 any day now.

ChicagoGranny wrote:

LSAT wrote:
I have been on Medicare/Medicare Advantage for 12 years. This is my second Medicare paid machine. No one ever asked me for compliance data.

Expect a bill for $479,312.34 any day now.

You never mention just who your provider is but should realize by now that it is up to your provider how they manage the policy NOT Medicare.

Unless I needed a new machine and asked for a prescription, I haven't had a doctor ever bring up apnea or CPAP in 12.5 years. I'm new to Medicare as of yesterday and it will be interesting as I'm about to ask for some mask parts!!

I just wanted to add that I speak of Original Medicare. LSAT has a Medicare Advantage plan and that works quite differently.

SewTired wrote:I just wanted to add that I speak of Original Medicare. LSAT has a Medicare Advantage plan and that works quite differently.

I was told that Medicare Advantage follows Medicare Guidelines. This may not answer the "New to Medicare question", but it may help someone..
https://www.resmed.com/us/dam/documents ... achine.pdf