Medicare Has Changed the Rules for Sleep Centers – We’re Ready!

Medicare has issued new rules for sleep centers in California, Nevada and Hawaii requiring accreditation by a national accrediting body effective June 5, 2017. The new rules, announced only last month, dramatically change the landscape for sleep centers. Many sleep centers are not accredited or may not meet the accreditation standards, and for new applicants the accreditation process may take months, so some sleep centers may find they cannot provide services to Medicare beneficiaries when the new rules take effect. 

Advanced Sleep Medicine Services is fully accredited and meets all the Medicare requirements, and will continue to provide services for all Medicare members without disruption.

As anybody who has gone through an accreditation or re-accreditation process knows, it’s difficult. For a sleep center, accreditation means we have to have detailed, adequate policies and procedures in place for all the important aspects of the facility, including clinical oversight, handling medical emergencies, confidential treatment of information, equipment maintenance and calibration, and the information provided to patients. The sleep center must be able to document compliance with the policies and procedures and to show that physician and staff credentials are complete and current. The sleep center must also have an active, substantial quality improvement program. 

The new Medicare rules require accreditation by either the Accreditation Commission for Health Care (ACHC), the American Academy of Sleep Medicine or the Joint Commission. Noridian Healthcare Solutions issued the new rule in a Local Coverage Determination (LCD). Here’s the link: Polysomnography and Other Sleep Studies Final LCD.

An organization’s quality improvement program is always a big part of healthcare accreditation. At Advanced Sleep Medicine Services, Inc. we are fortunate to have real leaders directing our quality improvement efforts. Our program includes trend reporting for tracking errors,complaints and suggestions, as well as patient satisfaction surveys. We look at various areas where we can improve our processes or results.  We also conduct in-house reviews of individual studies from the receipt of the physician order through the sleep test, scoring and physician interpretation. Our quality committee includes most of the management staff and meets one to two times monthly, with subgroups meeting weekly. We also focus strongly on staff training and extensive feedback.

Medicare has changed the rules, and in healthcare something is always changing, but Advanced Sleep Medicine Services is ready!