Safe use of donated positive airway pressure devices to increase access to treatment for obstructive sleep apnea: a clinical outreach program

Coverage to provide positive airway pressure (PAP) therapy for patients with obstructive sleep apnea (OSA) by the Centers for Medicare and Medicaid Services (CMS) and most private insurers is limited to those patients who meet diagnostic criteria for OSA based on a sleep study. Despite PAP therapy being a covered benefit by most insurers, many patients have high out-of-pocket costs due to copays and deductibles. Also, a subset of patients may be diagnosed per the American Academy of Sleep Medicine (AASM) recommended rule (H3A), while not meeting the diagnosis using the acceptable rule (H4) that their insurer requires.¹ To help patients such as these, our sleep medicine program envisioned and developed a PAP device donation program for patients with diagnosed or suspected OSA. Through our novel initiative, we were able to safely provide patients with donated and refurbished PAP devices at no cost to them. Here we outline the complexity involved in the provision of PAP therapy for patients with OSA and describe our PAP device donation program.