No Play, No Pay in France

Remote monitoring for CPAP compliance is alive and well in France, and if usage falls below certain levels, patients could be rated as “non compliant” and costs may no longer be reimbursed.

An recent article reports that people in France treated for sleep apnea have been subjected to remote monitoring where medical data is being recorded, transmitted (generally via the internet), and interpreted elsewhere—possibly leading to decisions on subsequent treatment. Patients’ associations have complained but reporter Dr. Nicoloas Postel-Vinay at the Georges Pompidou Hospital in Paris says their objections have so far gone unheeded.

“The number of patients receiving this treatment is steadily increasing and costs have soared, reaching €440m ($575m) in 2011,” writes Postel-Vinay. “Early in 2013 the French government published a decree requiring electronic sensors to be fitted and data to be transmitted to monitor use of the devices…For the first time in France coverage of health costs is conditional on patients wearing the mask during sleep.”

It is reportedly the first time that remote monitoring has been enforced to check patient compliance. Several organizations tried to stop the decree, and an appeal was lodged with France’s Conseil d’Etat, the highest administrative court.

“No one has any idea of the consequences of financial sanctions for poor compliance,” writes Postel-Vinay. “To help patients having difficulty following prescriptions, the international medical community and health authorities have promoted solutions based on decision autonomy and incentives…It is also unclear how much say doctors will have when confronted with monitoring results or, if prescriptions are justified, how they will be able to help patients.”

Source: Le Monde

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