My husband has been successfully using a BPAP machine for many years.  He has bad sleep apnea, diagnosed from a sleep study he went through many years ago.  The machine has worked wonders and changed his life.  Last week it quit working.  He took it in for repairs and was told the company was no longer in business, and parts were not available.  The supplier told him he would have to get another prescription from his doctor for a new machine.  The doctor refused to give him a prescription unless he goes for another sleep study.  We KNOW he still has the condition, and NEEDS this machine in order to function daily.  Going for another study will only cost Medicare money, but I guess it lines the doctor's pockets.

Does anyone know how to get a replacement for the original machine without going for another sleep study?  I'm not sure where to start on this and would appreciate some help.  He refuses to go back to the doctor.

I forgot to add that the company that supplied the original machine said that Medicare pays them $1800 for the machine--about $700 more that it can be bought for privately online.  Tell me someone isn't bilking the government.

Unless you have a copy of your husband's original equipment order (script) you won't be able to buy another bi-level thru an online DME supplier either.

Our needs change, at the very least your husband is going to have to go thru a Medicare approved at-home sleep study. He is being foolish to refuse to go thru another sleep evaluation and titration. It may well be possible that Medicare would approve a split-night study, altho I think that there is certain criteria that must be met in order to qualify for split-night payment.

Medicare is NOT interested in lining some doctor's pockets, nor any local DME supplier's pockets. Whilst it may be clumsy and not always the most efficient the Medicare guidelines for reimbursement are based on what they perceive as our best interests.

I would strongly suggest that your husband bite the bullet, have a new sleep study and get a new bi-level ASAP. And I would suggest that this time around he

1] get a copy of the doctor's dictated results
2] get a copy of the full scored data summary report w/condensed graphs
3] get a copy of the new equipment order (script)
4] insist on receiving a fully data capable bi-level (just because it has a data card doesn't mean an xPAP is fully data capable).

The equipment order (script) is good for life w/the online DME suppliers, only for a year in most states w/the local DME suppliers.

The above reports and the script are part of your medical records and assuming you are in the USA you have a legal right to copies under HIPAA.

With Medicare all accessories, i.e. mask, humidifier, hose, etc. are outright purchases at time of sale. The bi-level, however, is a 13 month capped rental after which it reverts to your full ownership.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

Unless you have a copy of your husband's original equipment order (script) you won't be able to buy another bi-level thru an online DME supplier either.

Our needs change, at the very least your husband is going to have to go thru a Medicare approved at-home sleep study. He is being foolish to refuse to go thru another sleep evaluation and titration. It may well be possible that Medicare would approve a split-night study, altho I think that there is certain criteria that must be met in order to qualify for split-night payment.

Medicare is NOT interested in lining some doctor's pockets, nor any local DME supplier's pockets. Whilst it may be clumsy and not always the most efficient the Medicare guidelines for reimbursement are based on what they perceive as our best interests.

I would strongly suggest that your husband bite the bullet, have a new sleep study and get a new bi-level ASAP. And I would suggest that this time around he

1] get a copy of the doctor's dictated results
2] get a copy of the full scored data summary report w/condensed graphs
3] get a copy of the new equipment order (script)
4] insist on receiving a fully data capable bi-level (just because it has a data card doesn't mean an xPAP is fully data capable).

The equipment order (script) is good for life w/the online DME suppliers, only for a year in most states w/the local DME suppliers.

The above reports and the script are part of your medical records and assuming you are in the USA you have a legal right to copies under HIPAA.

With Medicare all accessories, i.e. mask, humidifier, hose, etc. are outright purchases at time of sale. The bi-level, however, is a 13 month capped rental after which it reverts to your full ownership.

Also, keep in mind that the online DME suppliers get cash up front before you get your xPAP. Whilst the local DME suppliers on the other hand must shell out a pretty penny to have their xPAP inventory on hand but only receive reimbursement in piddly amounts drawn out over a 13 month period.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.