As of July 2020, health insurer Independence Blue Cross (IBC) has removed its prior authorization requirement for home sleep apnea tests following a dialog initiated by Itamar Medical to increase access. The dialog included presentation of evidence.

All membership (approaching 5 million members across 27 states) has been impacted within the Family of Companies, which includes Independence Blue Cross, AmeriHealth New Jersey, Independence Administrators, and AmeriHealth Administrators.

While Medicare does not require prior authorization for home sleep studies, many commercial health plans require it for their members.

“We are excited that undiagnosed patients of IBC with suspected obstructive sleep apnea can now more easily access the tests they need to confirm their diagnosis and manage their condition,” says Gilad Glick, president and CEO of Itamar Medical, in a release. “Sleep apnea is not only a serious ailment; it is also often an indicator and independent risk factor of other serious health disorders. We are committed to continue to lead the journey of reducing the barriers sleep apnea patients face as we develop a more efficient alternative to the traditional care pathway so that people can be diagnosed for sleep apnea safely, quickly, and efficiently from the comfort of their own bed. I want to thank the Baker Tilly health economic team in supporting our market access roadmap and this first win.”

Content Source:
https://www.sleepreviewmag.com/practice-management/money/reimbursement/home-sleep-testing-prior-authorization-requirement-removed-independence-blue-cross/