WPS Revised Sleep Lab Accreditation Requirement

Posted on May 15, 2017

Wisconsin Physician Services (WPS), the Medicare Administrative Contractor (MAC) for most Michigan hospitals, recently released an update to its local coverage determination (LCD) that took effect Feb. 16 for polysomnography and other sleep studies (L36839). Under this LCD, hospitals and other outpatient sleep centers that do not comply with the LCD requirements will not be paid for sleep lab services provided to Medicare fee-for-service beneficiaries.

In response to concerns received from the MHA and others regarding the revised requirements for sleep centers, which limited access to sleep lab services for Medicare patients, WPS modified the recent LCD. Based on the revisions, WPS will consider hospitals that had general accreditation by The Joint Commission prior to Feb. 16 to be in compliance with LCD L36839 if they apply for the required ambulatory care sleep specific credentialing with The Joint Commission within 90 days, or by Aug. 10. Hospitals must make the application and the letter from The Joint Commission available upon request by WPS. The final credentialing must be in place within 12 months, or by May 11, 2018.

As initially indicated by WPS, hospitals can also obtain accreditation from the American Academy of Sleep Medicine (AASM) or the Accreditation Commission for Healthcare (ACHC) to comply with the LCD. To assist hospitals in obtaining the accreditation, which can generally take three to six months, the AASM is offering an expedited accreditation process.

The MHA encourages hospitals to take the steps needed to obtain accreditation. Hospital staff are also encouraged to register for WPS eNews.

Two upcoming webinars will also be beneficial for hospitals affected by L36839. The Missouri Hospital Association, which coordinated the efforts among states impacted by the WPS LCD, will host a webinar 3:30 to 4:30 p.m. EDT May 22 to review details of the WPS notice released May 12, and advanced registration is required. The webinar will provide insight into WPS’s notification which allows accredited hospitals to immediately begin billing for sleep studies. Mark Crafton and Kristen Witalka from The Joint Commission will explain the process and advantages of obtaining sleep accreditation through The Joint Commission.

The Joint Commission will host a national webinar June 7 to review the accreditation requirements. The MHA will provide additional information regarding these webinars when it is available. Members with questions should contact Vickie Kunz at the MHA. 

This article was updated on May 24, 2017 to correct the date listed for The Joint Commission's national webinar to review the accreditation process. 

Tags: Medicare, webinar, WPS local coverage determination, sleep labs

Posted in: Member News

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