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    Accreditation changes may cause trouble for hospital-based sleep centers

    CGS Administrators, LLC, the Medicare Administrative Contractor for Medicare Jurisdiction 15, which comprises Parts A/B for Kentucky and Ohio, recently issued a local coverage determination (LCD) revising the accreditation requirements for polysomnography and other sleep studies. 

    Prior to the implementation of the new LCD, CGS required accreditation for billing purposes and recognized both Joint Commission Hospital and Ambulatory Care Accreditation programs. However, the new LCD (L36902) requires hospital-based sleep centers to obtain sleep-specific credentials from either the Joint Commission’s Ambulatory Care Accreditation Program, the American Academy of Sleep Medicine or the Accreditation Commission for Health Care. 

    The Joint Commission has issued a fact sheet regarding these recent revisions and has warned that its Hospital Accreditation Program may not satisfy CGS’ new requirements for services rendered after March 6, 2017 (the effective date of the new LCD). The Joint Commission has recommended that hospitals currently accredited under the Hospital Accreditation Program request an Ambulatory Care tailored survey for sleep services. Hospitals that successfully undergo such a survey will be granted dual accreditation (Hospital and Ambulatory Care).

    The Joint Commission is currently advocating with CGS regarding its changes to the accreditation requirements. On May 10, 2017, CGS issued an article clarifying the new accreditation requirements, which states that providers must apply for credentialing from one of the organizations listed above by August 8, 2017. Additionally, all sleep providers must have final credentialing completed by May 10, 2018.  Providers may request an extension to these deadlines if needed, but CGS has warned that extensions will only be granted for extenuating circumstances.

    This is for informational purposes only. It is not intended to be legal advice and does not create or imply an attorney-client relationship.

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