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Point/Counterpoint Editorials |

Counterpoint: Should Board Certification in Sleep Be Required to Prescribe CPAP Therapy on the Basis of Home Sleep Testing? NoBoard Certification for CPAP? No

Peter C. Gay, MD, FCCP
Author and Funding Information

From Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Mayo Foundation for Medical Education and Research.

Correspondence to: Peter C. Gay, MD, FCCP, Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Mayo Foundation for Medical Education and Research, E18B, Rochester, MN 55905; e-mail: pgay@mayo.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(6):1754-1756. doi:10.1378/chest.13-1699
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Comparative effectiveness and least costly alternative diagnostics and therapies have become powerful mantras within Centers for Medicare & Medicaid Services (CMS) policies. These concepts played a role in the decisions by CMS to eventually provide reimbursement for home sleep testing (HST). This was based on supportive evidence proving that spending the higher cost of in-laboratory polysomnography (PSG) produced the same outcome; therefore, Medicare supported the least costly alternative of HST.1 Now, HST has become a mainstay in the diagnosis and management of patients with uncomplicated OSA. Most recently, the Agency for Healthcare Research and Quality published their report on the diagnosis and treatment of OSA in adults.2 They proposed that a future research-needs topic would be to examine the value of having a sleep medicine specialist involved in the diagnosis of OSA.

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