Medicare Refusing Payment for BiPap
Original Post: I have been using a BiPAP machine for 8 years. Medicare has been paying for the BiPAP and for the necessary supplies until recently. After paying for 10 months of the required 13 month rental of a new BiPAP machine, Medicare suddenly denied coverage claiming Post-Polio Syndrome is not a neuromuscular disease. I am appealing the decision and need documentation to support that Post-Polio Syndrome is indeed a neuromuscular disease.
Dr. Bruno’s Response: Getting BiPAP has absolutely nothing to do with Post-Polio Sequelae being a neuromuscular disease. It certainly is a neuromuscular disease and the federal government recognizes that fact (See Social Security Ruling for Post-Polio Sequelae under the topic “Social Security” in the Encyclopedia of Polio and PPS.)
The real question is whether you have a sleep disorder that requires BiPAP. It doesn't matter what causes your sleep disorder; all that matters is that you have documentation of the need for BiPAP. Your lung doctor needs to send the letter in to appeal the denial. You may end up needing help from your congress person / senators for help in overturning the Medicare denial.