Getting official medical help with osa and sp02 levels?

[ravenous28]

Yep going down there today to get all my records she’s printing up for me in regards to 2012 sleep study and what ever else. And also to sign off and sign over the paperwork to leave and go to a new medical place for a different pcp

[ravenous28]

He’s not worth the appointment money. I’m better off finding a better doctor and staring over at this point.. I’m due for my free physical this year anyway with my insurance so it’s time to switch anyway

[ChicagoGranny]

He’s not worth the appointment money. I’m better off finding a better doctor and staring over at this point.. I’m due for my free physical this year anyway with my insurance so it’s time to switch anyway

+1

[bwexler]

I find it takes me about a year to train a PCP. If they refuse to be trained they can be replaced in a month.
With my current PCP there is a patient portal on line where we can communicate. If I need a prescription or pre approval for something I send a request and it is generally there in a day or two. If she disagrees she responds in an hour or two and we determine a path forward. She knows I am in charge of my care and cooperates unless she sees a problem.
Admittedly, she pays little attention to my sleep therapy or my warfarin therapy, but I keep her informed at least annually.

[Jay Aitchsee]

Nope they won’t give it to me. She said it expires every year based upon medical rules and the said dr would be liable if god forbid the machine was set to the wrong numbers and something were to happen to me.

This is absolute rubbish. There is no medical rule that requires a CPAP prescription to expire annually. Doctors could write them to expire annually (to comply with insurance requirements, for example) if they wish, but there is no rule that requires it. The default expiration of CPAP prescriptions is understood to be 99months/Life. See https://www.easybreathe.com/Prescriptio ... w-120.html

It would be interesting to learn the basis of this person's statement. Perhaps when you go in, you could ask her to cite the rule.


A cpap is considered a Class II medical device which require a prescription. See https://aasm.org/fda-reclassifies-posit ... al-device/

See: https://www.alaskasleep.com/blog/cpap-p ... n-for-cpap

How long a prescription is valid for depends on the duration that the prescribing physician recommends. Most PAP prescriptions are filled out for a lifetime prescription.

[OfftoNeverNeverland]

While the article pasted via link below is an egregious example (January 2018), it is clear that selling Class II medical equipment (CPAP) without being licensed to issue a prescription for such Class II equipment is a federal criminal offense. Any one of us is unlikely to be prosecuted unless you are buying/selling a lot of Merch like this couple. The FDA brought charges against this DME couple based on the federal statutes they are empowered to enforce. Note that the couple were not just charged for theft (a state crime) but instead were federally prosecuted for selling CPAPs to civilians (us) under the table that they had just allegedly stolen. In short, instead of being an accessory to a federal crime (potentially) just find someone who can issue a CPAP prescription. You can adjust the legal CPAP yourself from info easily found on this blog.

https://www.justice.gov/usao-ndga/pr/co ... al-devices

[palerider]

While the article pasted via link below is an egregious example (January 2018), it is clear that selling Class II medical equipment (CPAP) without being licensed to issue a prescription for such Class II equipment is a federal criminal offense. Any one of us is unlikely to be prosecuted unless you are buying/selling a lot of Merch like this couple. The FDA brought charges against this DME couple based on the federal statutes they are empowered to enforce. Note that the couple were not just charged for theft (a state crime) but instead were federally prosecuted for selling CPAPs to civilians (us) under the table that they had just allegedly stolen. In short, instead of being an accessory to a federal crime (potentially) just find someone who can issue a CPAP prescription. You can adjust the legal CPAP yourself from info easily found on this blog.

https://www.justice.gov/usao-ndga/pr/co ... al-devices

What the article linked *actually* says is

are charged with conspiring to steal medical products that can be obtained only with a prescription and possession of the same stolen medical products. They are also charged with multiple counts of theft of such medical products and possession of stolen medical products

A brief search didn't reveal anything else about the case, just the arraignment. Does anyone have any info on disposition? Just because they were charged doesn't mean they were found guilty of theft.

Also, few if any people that *sell* cpaps are licensed to issue a prescription.

[ravenous28]

I got an appointment setup in the next 2 weeks with a new dr and plan on trying to start over again. I guess what I’ll ask for is if it’s possible for me to try cpap again on a trail again so I can be in compliance on the record medically, then after that see if I’m able to get my own prescription. Sort of dumb since i already have a cpap machine sitting on my bedside which works fine for me.

In regards to what’s legal or not I don’t know the rules. Is it wrong for a family member to let someone use a cpap they own already vs someone selling one they own online to a stranger. Seems as if the nurse was telling me that cpap can actually end up harming someone more who has osa then good? I don’t see how that can really be. I think what’s harmful is someone not choosing to do anything about their osa from the getgo.

From my standpoint it’s already medically documented I have osa on my medical reports and I did a cpap overnight test with one in 2012 and it even says in the discharge paper that I tolerated cpap all night and all issues were taken care of on 15cm with sp02 etc. what my doctor is doing is basically forcing me to wait and spend more money and time not helping treating my osa. Months if not longer just to let some other dr decide if he wants to give me another chance on the cpap. I wouldn’t have a extra cpap given to me and be in this situation first if my dr wasn’t banning me from trying to use it again. Now I’m so far in non compliance that i hope this next dr doesn’t give me issues for already having a cpap. This whole thing is a mess really.

[bwexler]

This is only a mess because you are allowing it to be a mess.
Go to the new Dr with a stack of Sleepyhead reports and probably a written explanation of what you have been through. Let the new Dr read it all so you don't get upset and flustered in a conversation. Explain in writing that you already have a APAP machine but would like a prescription for a new one should you ever need it and for masks and supplies of your choice. This prescription should expire in 99 years and be written and handed to you before you leave the office.
If this is all written and handed to the doctor as he enters the exam room, this part of the visit should take less than 5 minutes.
You can then get on with the rest of your visit.
Another thing I insist on is getting any blood work done early enough so I can have the results back before my visit and have time to Study it and write any questions I may have. This practice allows me to reduce the number of visits and get many more questions answered in the allotted time. I also don't forget half my issues while the doctor is asking new questions or answering my first question.

By the way I fill out my own lab test request and have my doctor approve and sign it.
I had my annual blood drawn this morning. I will schedule my appointment for my annual physical in about 2 weeks. That should allow time for the lab to do their magic and me to Study the results.

[Jay Aitchsee]

In regards to what’s legal or not I don’t know the rules. Is it wrong for a family member to let someone use a cpap they own already vs someone selling one they own online to a stranger. Seems as if the nurse was telling me that cpap can actually end up harming someone more who has osa then good? I don’t see how that can really be. I think what’s harmful is someone not choosing to do anything about their osa from the getgo.

This is only a mess because you are allowing it to be a mess.

Absolutely, you are getting too hung up on the legalities. It is only illegal for a business (DME) to sell a cpap machine to someone that doesn't have a prescription. The prescription applies to the sale of machines by businesses (DME). It is not illegal to have or use a cpap machine without a prescription. It is not illegal for you to buy a cpap machine without a prescription, it is not illegal for someone to give you a cpap machine without a prescription, it is not illegal for an individual to sell or give away a cpap machine to anyone with or without a prescription.

Tell your doctor your history, what you have, and what you want to do and ask him to write a prescription. Now, the doctor doesn't have to write you a prescription if he doesn't want to, but the biggy is that the insurance company may have additional requirements, in addition to a prescription, before they will fund a purchase on your behalf, even if the Dr writes a prescription.

Don't let this prescription stuff confuse you. Prescriptions are used to control the sale of machines by Durable Medical Equipment providers (DME) and by Insurance Companies as a basis for claim reimbursement. If you don't need insurance, half the battle is won.

[ravenous28]

This is only a mess because you are allowing it to be a mess.
Go to the new Dr with a stack of Sleepyhead reports and probably a written explanation of what you have been through. Let the new Dr read it all so you don't get upset and flustered in a conversation. Explain in writing that you already have a APAP machine but would like a prescription for a new one should you ever need it and for masks and supplies of your choice. This prescription should expire in 99 years and be written and handed to you before you leave the office.
If this is all written and handed to the doctor as he enters the exam room, this part of the visit should take less than 5 minutes.
You can then get on with the rest of your visit.
Another thing I insist on is getting any blood work done early enough so I can have the results back before my visit and have time to Study it and write any questions I may have. This practice allows me to reduce the number of visits and get many more questions answered in the allotted time. I also don't forget half my issues while the doctor is asking new questions or answering my first question.

By the way I fill out my own lab test request and have my doctor approve and sign it.
I had my annual blood drawn this morning. I will schedule my appointment for my annual physical in about 2 weeks. That should allow time for the lab to do their magic and me to Study the results.

Yeah, I can try that all that. They probably have no idea what sleepyhead is. I’d be better off showing them the results from the official resmed my air app with the airsense 10 auto on my phone to prove its working. But I really have no problem wasting their time explaining my situation either, they make enough to hear me out. I certainly can’t force them to agree with me that cpap is ok for me or give me a prescription. I’m willing to pay for a trail on it for a month if need be with insurance. Like I said, I already asked my old dr if coming back to cpap was an option after 7 years on the mouthpiece and I was told I need to see a sleep specialist to decide next.

What I guess I don’t get is what exactly is the sleep specialist going to recommend I do to treat the osa? Sure I can go deeper and into tests, go to an ent to get re-evaluated I’m normal, but I’m not trying to get throat surgery here or implanted with an inspire device. Maybe they will just tell me the easiest solution is to strive to lose weight and sleep on my side. Either way the mistake I made was failing the cpap trail and thinking the mouthpiece was treating my osa this whole time. Knowing my luck I’ll have to do the whole stay over night at a lab all over again. But I’ll see what this new dr says about it.

[ravenous28]

In regards to what’s legal or not I don’t know the rules. Is it wrong for a family member to let someone use a cpap they own already vs someone selling one they own online to a stranger. Seems as if the nurse was telling me that cpap can actually end up harming someone more who has osa then good? I don’t see how that can really be. I think what’s harmful is someone not choosing to do anything about their osa from the getgo.

This is only a mess because you are allowing it to be a mess.

Absolutely, you are getting too hung up on the legalities. It is only illegal for a business (DME) to sell a cpap machine to someone that doesn't have a prescription. The prescription applies to the sale of machines by businesses (DME). It is not illegal to have or use a cpap machine without a prescription. It is not illegal for you to buy a cpap machine without a prescription, it is not illegal for someone to give you a cpap machine without a prescription, it is not illegal for an individual to sell or give away a cpap machine to anyone with or without a prescription.

Tell your doctor your history, what you have, and what you want to do and ask him to write a prescription. Now, the doctor doesn't have to write you a prescription if he doesn't want to, but the biggy is that the insurance company may have additional requirements, in addition to a prescription, before they will fund a purchase on your behalf, even if the Dr writes a prescription.

Don't let this prescription stuff confuse you. Prescriptions are used to control the sale of machines by Durable Medical Equipment providers (DME) and by Insurance Companies as a basis for claim reimbursement. If you don't need insurance, half the battle is won.

I wouldn’t want to purchase through insurance anyway because the cost is twice as much as if you buy your own online. But I can’t buy online from any of these places unless I have a valid prescription. That’s my dilemma. I also sort of want to let my dr know this is what I choice to do. It’s the whole hang up that the drs have controlling who can and cannot get a cpap easily. It has to be all about money otherwise I don’t see a valid reason why cpap couldn’t be sold otc to anyone.

[Jay Aitchsee]

I wouldn’t want to purchase through insurance anyway because the cost is twice as much as if you buy your own online. But I can’t buy online from any of these places unless I have a valid prescription. That’s my dilemma. I also sort of want to let my dr know this is what I choice to do. It’s the whole hang up that the drs have controlling who can and cannot get a cpap easily. It has to be all about money otherwise I don’t see a valid reason why cpap couldn’t be sold otc to anyone.

Then just tell your doctor want you want to do and ask for a prescription. Remember, any doctor or dentist, can write a prescription. Remember, too, that a doctor works for you. You are hiring him to help you achieve good health. You are paying him for advice and assistance. If that advice and assistance is not helpful, find another doctor. Simple as that. Tell him/her you have a machine and need assistance in using it properly which includes a prescription in order to purchase supplies online.

Of course it's about the money.

[sleepye]

Somebody correct me if I am wrong, but I thought the only reason one would need to prove compliance is to get insurance to pay for things. Compliance does not really have anything to do with whether you may get a prescription. In my case many (10-ish?) years ago, I got a prescription for a machine and supplies. Using the prescription a DME gave me a machine for which my insurance company paid a portion. The insurance company required it to be rented rather than purchased outright if they were going to contribute to the cost. During the rental period until I owned the machine I had to show compliance so the insurance company would continue paying their portion.

[ravenous28]

Somebody correct me if I am wrong, but I thought the only reason one would need to prove compliance is to get insurance to pay for things. Compliance does not really have anything to do with whether you may get a prescription. In my case many (10-ish?) years ago, I got a prescription for a machine and supplies. Using the prescription a DME gave me a machine for which my insurance company paid a portion. The insurance company required it to be rented rather than purchased outright if they were going to contribute to the cost. During the rental period until I owned the machine I had to show compliance so the insurance company would continue paying their portion.

Back in 2012 I did go to a dme and got a resmed s9 for my trial and it went through my insurance. One would think I have a prescription then but the lady said she doesn’t see one only an order number from the dr on file. And when I asked his nurse about the fact that I should have a prescription then and i would like a copy, she then started to tell me it doesn’t matter anyway because the prescription would be expired because if only lasts a year and only the dr could approve and write me a new one. Totally doesn’t make sense.