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New Sleep Management Program Improves Convenience, Compliance, and Affordability

Beginning July 1, 2013, we will introduce a sleep management program for our HMO and POS members (excluding Medicare Advantage) to improve convenience and enhance health care affordability. The program will help physicians and clinicians to:

  • Improve site-specific appropriateness for sleep disorder testing and therapy services
  • Better manage cost-effective equipment and services
  • Monitor member compliance with prescribed sleep therapies

Tests and treatment that require prior authorization are:

  • Home sleep test
  • In-lab sleep study
  • Titration study
  • Initial and ongoing treatment orders for equipment and supplies related to sleep therapy, including APAP, CPAP, BPAP devices
  • Oral appliances for sleep therapy

To further help reduce costs, we will no longer authorize the use of equipment that is not being utilized by the member.

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