The American Academy of Sleep Medicine (AASM) urges the Oklahoma Health Care Authority (OHCA) to reinstate coverage for diagnostic sleep studies and CPAP for adult Medicaid patients.
The OHCA board has indicated that it recognizes the potential medical benefits of these sleep medicine services. However, the state’s severe budget crisis led to the recent decision to eliminate coverage of sleep studies and CPAP therapy, which the state considers to be “optional” services. The decision puts thousands of Oklahoman Medicaid patients at risk for developing serious comorbid diseases such as heart disease, stroke, hypertension, Type 2 diabetes, and depression.
“These cuts will lead to increased medical expenses over time because they make it impossible to diagnose and effectively treat Medicaid patients who have obstructive sleep apnea and other sleep disorders including narcolepsy, REM sleep behavior disorder, and central sleep apnea,” says Vikas Jain, MD, a board-certified sleep medicine physician who practices in Oklahoma City, in a release. “Chronic disease care is not optional: It is essential for individual health and well-being, and it is critical for the financial viability of a health care system.”
In comments submitted to the OHCA prior to its final decision, AASM warned that untreated sleep apnea significantly increases the risk of other costly diseases, leading to a higher rate of health care utilization and greater health care expenses. It is estimated that the overall annual economic cost of untreated sleep apnea in the United States is up to $165 billion. However, effective diagnosis and treatment with CPAP therapy can reduce the health and safety risks associated with obstructive sleep apnea, thereby decreasing health care utilization and costs.
“Medical coverage for chronic sleep disorders care is essential for individual and population health,” says AASM president Nathaniel Watson, MD, MSc. “As Oklahoma lawmakers consider strategies to balance the state budget, the American Academy of Sleep Medicine urges state officials to ensure that Medicaid patients with obstructive sleep apnea have access to the medical care they need to achieve optimal health.”