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The one main thing I have gotten out of this discussion is that there is a distinct possibility that
'unauthorized' self-titration could POSSIBLY result in insurance coverage problems.
Insurance companies--bleah.

chunkyfrog wrote:The one main thing I have gotten out of this discussion is that there is a distinct possibility that
'unauthorized' self-titration could POSSIBLY result in insurance coverage problems.
Insurance companies--bleah.

Hi

The only reason we even mess with pressure is to get the best possible therapy for our selves which would be proven out by our lower AHI events ect so how could they then say this was bad If I improved my numbers

The more I think about this the INS co does not cancel me If I'm non compliant if my prescribe pressure doesn't work for me they also don't cancel me or refuse treatment because I'm fat both will kill me or do more harm faster than if I set my pressure a little higher

Gary

I am enjoying this conversation very much. XJ made a very good initial post. It was not trolling, it was not flaming, so I was upset when i saw others get upset over the conversation. I have read (and written) enough legalese over the years that I know he was not blowing smoke.

I have read somewhere that the average person commits three felonies a day. That is how messed up our laws are. The US has more laws than any other country, and that is not a good thing. In fact, one of the really complex parts of writing a new law (or agency rule) if figuring out how they impact other laws/rules. Too many laws, too little freedom. In that regard, I fully agree with SuperSleeper.

XJ finally did show us that under a fairly obtuse interpretation, it might indeed be illegal to adjust your own CPAP pressure(s). But few or none of these obtuse interpretations have yet occurred, nor do I see it happening soon.

So, I would not have any fear adjusting your own pressure. In fact, when I first got my ASV unit, there was one setting that was grossly wrong. Within 45 minutes of first use, I had corrected it, and have not had to adjust anything else since. My doctor was happy when I told him about it because the setting I used was the setting he really wanted, and the information had been incorrectly copied by the RT.

This will probably be my last post on this board. For the last 20 minutes, the CPAP police have been outside with a bullhorn, saying 'come out with your mask on' and 'exit that clinician's menu NOW'!. Now, they are preparing to break the door down. Thank you all folks, its been good kn...................

I would be more worried about Resmed conspiring the the DME community to mandate a wireless control device that can monitor your settings and change them back without you knowing ... all in the name of compliance. Thats what it will come to I think if you want to be reimbursed by the government/insurance complex you will sign up to be monitored for compliance. Forget the legalities, they will just have a computer program monitoring and resetting your machine at night while you sleep.

lol @timba i totally agree we have too many laws. and vagueness incorporated into laws allow the legal eagles to interpert them to thier best advantage.
when it comes down to it the legal system runs this country. we can elect all the representatives and administrarors we want but when the courts rule -that;s it . period. end of story. instead of reworking old laws they keep making new ones ignoring old ones making it impossible for the average person to knowingly act within the law.
add to the confusion is the fact that laws are sparsely published or posted in a public place. and even if they were posted in a public place; if you are a slow reader and lingered too long reading it you'd be guilty of loitering thus the legal elite have provided for themselves job security at the expense of those they purport to serve.

is it legal to change your own pressure? depends on how much you pay to get your lawyer to persuade the ruling judge(another lawyer) that in your case of circumstance you did not violate the law as written (or on appeal as how the law was intended)

we may never know

i am enjoying this thread and i thank the OP for starting it.


i think what we all want to see here is the actual text of the laws prohibiting it and a way to validate such posting

It is an interesting argument. But in the scheme of things that I worry about, it is not high on my list.

This thread has been entertaining and certainly makes me think of all the things I do during the day that are illegal. Some days I only take 1/2 tablet of my prednisone dosage even though it clearly says to take 1 tablet. Sometimes I skip it altogether--gasp! I try very hard to drive the speed limit, however sometimes going down hills, especially when there is someone riding on my behind, I may go a little over the speed limit. My dog sometimes escapes the house and has run up the street without her leash--with me chasing her all the way--but this still breaks the law. I also break city ordinances several times a week, by leaving my trash can at the street past 6 pm, or letting my grass at the very back of my yard grow beyond the designated 8 inch height. And yes, I have fiddled with the pressure on my CPAP. My Rx does not even specify a pressure and even though the RT issued me a straight CPAP and verbally told me what the machine was set to; when I went to buy a second one so I could have a backup, I could only purchase an auto with the pressure set wide open--which I changed as soon as I received it. Maybe that gets me out of the legal/illegal dilemma?

In a perfect(thus imaginary) world, we would all have wonderful, attentive doctors and fabulous DMEs. We would be able to go to the doctor any time we needed to, doctors would be conveniently located, it would be affordable, we would get a correct diagnosis, would not have to beg a doctor to listen to our problems, would never need a second opinion, and would always get good care. Sadly, this is not the case, and many people are left to their own devices. Most of us just do the best we can to get by. We try to get through the day (and night) without hurting others, without damaging ourselves.

“If you give me six lines written by the hand of the most honest of men, I will find something in them which will hang him”

- Cardinal Richelieu

I can think of dozens of laws that police officers violate on a near daily basis. My favorite are the sodomy laws because most likely every prosecutor, judge, jury member, and persons in the court room has violated them.

I can't imagine how anyone could legally find that adjusting your pressure is "illegal". It would be just like how a diabetes patient changes his amount of insulin just outside of the zone that the Dr. and he spoke about (without an "order" to not violate those limits). There are dozens of ways that patients change their treatment that are outside the zone of what the doctor has prescribed, or recommended.

I can only see the 11 cm of pressure that my Dr. has prescribed a recommendation and not a "order" that can't be violated.

No legislative body, sufficiently informed, would find that changing pressure illegal. That's my opinion, and I'm sticking to it.

Guest wrote:It is an interesting argument. But in the scheme of things that I worry about, it is not high on my list.

This thread has been entertaining and certainly makes me think of all the things I do during the day that are illegal. Some days I only take 1/2 tablet of my prednisone dosage even though it clearly says to take 1 tablet. Sometimes I skip it altogether--gasp! I try very hard to drive the speed limit, however sometimes going down hills, especially when there is someone riding on my behind, I may go a little over the speed limit. My dog sometimes escapes the house and has run up the street without her leash--with me chasing her all the way--but this still breaks the law. I also break city ordinances several times a week, by leaving my trash can at the street past 6 pm, or letting my grass at the very back of my yard grow beyond the designated 8 inch height. And yes, I have fiddled with the pressure on my CPAP. My Rx does not even specify a pressure and even though the RT issued me a straight CPAP and verbally told me what the machine was set to; when I went to buy a second one so I could have a backup, I could only purchase an auto with the pressure set wide open--which I changed as soon as I received it. Maybe that gets me out of the legal/illegal dilemma?

In a perfect(thus imaginary) world, we would all have wonderful, attentive doctors and fabulous DMEs. We would be able to go to the doctor any time we needed to, doctors would be conveniently located, it would be affordable, we would get a correct diagnosis, would not have to beg a doctor to listen to our problems, would never need a second opinion, and would always get good care. Sadly, this is not the case, and many people are left to their own devices. Most of us just do the best we can to get by. We try to get through the day (and night) without hurting others, without damaging ourselves.

Sorry, the above post was mine--did not realized I was not logged in! (Actually I was afraid the prednisone police might be monitoring the board

Okay, okay, okay, hold the phone for a minute.

While it is one thing to quote a law, you have to look at all updates and supplements as to how that law currently stands today, and is weighted, changed,modified by any case law. And that always has to be done before throwing around statutes, codes, etc., around like they mean anything. Plus I can see an attorney making an argument FOR or AGAINST making any of those statutes, codes, etc., being held applicable to the patient who changed their XPAP pressure.

The next thing....we all have different employment backgrounds, so I don't know what all of you do, but maybe you can relate from watching say, "Law and Order", or that type of show. Can you imagine the law enforcement Court Filing Officer going to the District Attorney and saying, "well, we have this case we want you to file on. It's a VERY serious case where Suzy Jones has changed the settings on her APAP machine." I can hear the laughter now. And probably some expletives and also "GET THE HELL OUT OF MY OFFICE" too as the District Attorney would be calling the Chief of Police to report the police Court Filing Officer is off her rocker. Also since District Attorneys and Deputy D.A.'s all have been facing cutbacks and those offices can't even hardly process the DUI's and petty theft cases, and their resources are really stretched to keep the REAL bad guys in jail -- so now we're going to talk about "IT'S AGAINST THE LAW?" The law is only the law if someone is willing to enforce it and prosecute it -- and folks that won't be on changing a XPAP pressure EVEN IF it were against the law (which is still so debatable according to where you live).

Sooooo if we follow this "you're breaking the law" line of reasoning, then so we would call the police and have a report written up for Suzy Jones for changing her APAP pressure? I can hear the police dispatchers cracking up over that one also.

I was in the dispatch center one day and heard this:
Dispatcher: "9-1-1 state your emergency."
Caller: "I'm outside this liquor store and this guy won't sell me the potato chips I want. He kicked me out of his store."
Dispatcher: "Well sir, the police are not going to make him sell you the potato chips, and it's his property, if he doesn't want you in his store, that's his decision."

So, the police can't make people serve customers they don't want to serve, and the police is not going to make people stop changing their changing their XPAP pressures.

So, the dispatch call would sound like this:
Dispatcher: "9-1-1 state your emergency."
Caller: I am a physician (or DME, or R.T.) and I want to make a report on a patient who changed their pressure on their XPAP machine."
Dispatcher: That's a civil matter between the physician and patient.

And you can't make a D.A. file on it, and so even if Congress passed a law tomorrow, Obama signed it, and the Supreme Court upheld it and this law says, "THOU SHALL NOT CHANGE YOUR OWN XPAP PRESSURE".....who the heck would enforce such a thing? And who would prosecute it?

Hell, law enforcement can't even get people to stop beating their wife, not keep the cocaine down on the coffee table where the 2-year-old ingests it, stop raping, murdering, robbing, and stealing, drugging.........HOW would law enforcement OR ANYONE ever enforce XPAP pressure changes by the patient.....?

This is the MOOTEST of MOOT points! So, it's sort of silly for anyone to throw at us ever "That's against the law."

When I asked the R.T. about wanting software for my machine, she said something like "that's wrong, no one should have access to that but the DME or doctors and if anyone tells you how to get the software, that's wrong too." She didn't even tell me it was against the law, and if she had, it wouldn't have stopped me anyway. I wanted to see my data, and I was going to, even if I had to buy the software on the black market (ooooooooooooh another law almost broken )

Okay, just my 0.02 cents. (wink wink)

you're busted donna!!!!!!!!!!!!

true junebug but it really depends on the money involved. Downloading music isn't exactly a dangerous felony either but you can end up in court and paying $90,000 per song you downloaded. There are civil lawsuits too as well as the drama versions. I could sort of see DME's coming after their clients for the cost of the change. They could make you sign a contract that any changes will be done by them kind of like when you download software you agree to the user agreement.

chunkyfrog wrote:The one main thing I have gotten out of this discussion is that there is a distinct possibility that
'unauthorized' self-titration could POSSIBLY result in insurance coverage problems.
Insurance companies--bleah.

I agree and even think that POSSIBILITY is very remote. Insurance companies care about compliance. If accused, most people would claim a machine malfunction anyway, or claim it was accidental.

Some of the docs, DME's, R.T.'s I have dealt with are too busy to tell me what I need to know (had to learn it all here) let alone have time to check that I have changed pressure or not (even though doc said I could).....BUT he did that at MY SUGGESTION -- again, based on what I have learned here.

But then again, my case is not severe, and I don't have centrals. But I have seen the "experts" on here -- those of you who give great info, I have seen all of you be prudent and careful to refer people to their Docs, and R.T.'s and DME's when necessary.

BlackSpinner wrote:true junebug but it really depends on the money involved. Downloading music isn't exactly a dangerous felony either but you can end up in court and paying $90,000 per song you downloaded. There are civil lawsuits too as well as the drama versions. I could sort of see DME's coming after their clients for the cost of the change. They could make you sign a contract that any changes will be done by them kind of like when you download software you agree to the user agreement.

I don't agree. I would worry about changing my pressure setting about as much as I worry about a satellite falling outta da sky and landin' on my house!

Those DME's are too busy selling used equipment as new (not all, but we know it happens), and too busy selling equipment out the door to people who take it home, try it out for a few nights or long enough to own it and then stick it in their closets.

I'll put it this way: if you get fined for $90,000 per pressure change, I'd be happy to pay for it

It's the mootest of moot points. People break all sorts of laws and break "contracts" all the time on stuff that is inconsequential and no one ever does anything. The downloading music and breaking copyright laws is a huge loss of money....so of course they had the attorneys to go after this.....but NO ONE is going to go after us for changing our pressure even IF a law it plain, simple, and applies to all of us all the time.

Nah, you could say, "well DUI is breaking the law, and people get thrown in jail for that, and people get fined for that, and causing an accident while DUI will cost you to pay restitution fees."....yeah, that happens....but again, no one is going to do that over XPAP pressures.....not now, not ever....this society is holding on by a thread to whatever is going now, there is no time, no resources to go after a private individual for changing their own XPAP pressure. Besides, there is no money in it.

For instance, if you changed your pressure say 3 times in last 3 months, so you could possibly owe "$270,000"? Would you even worry about paying for that? Id' think a person would be better off worrying about that satellite hitting their house than spending time worrying about civil or criminal consequences of changing their XPAP machine.

Oh P.S.....I do MOST HUMBLY apologize if any of that sounds like coming on too strong -- wouldn't want to do that -- and reading it I do sound way TOO "bossy". But was just giving my opinion....such as it is : )

I've worked in civil law, and now work in criminal law.....and a lot of people worry about being sued or about breaking laws that really aren't that big of a deal. I didn't download free music because I am also a musician and thought it would be wrong to do that......but I'd still not hesitate to change MY APAP pressure....because it's my life, my health, my sleep....I'm not stealing from anyone to do that. Really, don't worry about it -- I think we just all need to worry about getting a good night's sleep.

Well on page 283745773 of the new insurance bill passed by congress, they have a 40% tax on cpap pressure. They have discovered we using more oxygen than nesscessary and need to pay for it. There will be a government official at your house to tuck you in and check pressure and collect each and every night. Those who refuse to pay will forfeit their homes. john

jlk wrote:Well on page 283745773 of the new insurance bill passed by congress, they have a 40% tax on cpap pressure. They have discovered we using more oxygen than nesscessary and need to pay for it. There will be a government official at your house to tuck you in and check pressure and collect each and every night. Those who refuse to pay will forfeit their homes. john