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OSA with documented CPAP failure establishes medical necessity, bypasses step therapy, and unlocks better access for the same 655 million patients

doi: 10.1136/bcr-2020-241547 [PubMed] 34625331 Cunningham D, Clark K, Lord K

10.1002/jnr.23181 180 WegmannS.BiernatJ.MandelkowE

We refer readers to the FY 2011 through FY 2025 IPPS/LTCH PPS final rules for discussions regarding this provision, including our methodology for identifying which areas meet the definition of frontier States as provided for in section 1886(d)(3)(E)(iii)(II) of the Act: for FY 2011, 75 FR 50160 through 50161