However, in the US health-care system, the use of ULCT cannot be as controlled as it was in these studies. Since Centers for Medicare and Medicaid Services approved ULCT as a viable diagnostic option for the use of CPAP, several companies have sprung up to market this technology. The business model I have seen most often is to offer it to primary care providers (PCPs) as a simple and easy way to diagnose sleep apnea “without the hassle” of using a sleep center. The patient undergoes the testing, the study is “interpreted” by a physician who presumably has some expertise in such interpretations but usually does not ever see the patient, and the report is sent to the ordering physician. He can then order a CPAP device, send the patient to a surgeon or dentist, or recommend some other form of therapy. The decision about which patient to perform this testing on is made by the PCP, and little is known currently about how they are making that determination. Indeed, it may be that this is a very reasonable approach and that most patients will be adequately diagnosed and treated. One could argue that with CPAP adherence being 50% in the best hands, why should sleep specialists think that PCPs will do any worse?