2013 Session

Budget Amendments - HB1500 (Member Request)

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Chief Patron: Jones
Medicaid Requirements for Testing & Treating Obstructive Sleep Apnea

Item 307 #36h

Item 307 #36h

First Year - FY2013 Second Year - FY2014
Health And Human Resources
Medical Assistance Services, Department of FY2013 $0 FY2014 $430,000 GF
FY2013 $0 FY2014 $430,000 NGF

Page 263, line 15, strike "$8,033,837,513" and insert "$8,034,697,513".
Page 280, after line 14, insert:  
"JJJJ.  The Department of Medical Assistance Services shall amend the State Plan for Medical Assistance to allow for the implementation and reimbursement of innovative methods and technology used in the diagnostic testing and therapy of Obstructive Sleep Apnea (OSA) to lower costs and improve outcomes in sleep care and associated chronic health conditions for Medicaid recipients.  Such methods and technology may  include the use of home sleep studies and home testing equipment.  The department shall have the authority to implement this change effective July 1, 2013, and prior to the completion of any regulatory process undertaken in order to effect such change."

(This amendment adds language directing the Department of Medical Assistance Services to implement and provide reimbursement for the use of innovative methods and technology in the testing and treatment of Medicaid recipients with Obstructive Sleep Apnea. Obstructive sleep apnea (OSA) occurs when there are repeated episodes of complete or partial blockage of the upper airway during sleep. These episodes can reduce the flow of oxygen to vital organs and cause irregular heart rhythms. Without treatment, the sleep deprivation and lack of oxygen caused by sleep apnea increases health risks such as cardiovascular disease, high blood pressure, stroke, diabetes, clinical depression, weight gain and obesity. The most serious consequence of untreated OSA is to the heart. Sleep apnea sufferers have a 30% higher risk of heart attack or death than those unaffected. Currently, most tests are performed in hospitals or free-standing sleep labs. Advancements in technology and home testing equipment have made home sleep studies a more cost effective and convenient alternative for most patients to test and treat OSA.)