The America Sleep Apnea Association stated, “It is estimated that 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed.” A device known as a CPAP, or continuous positive airway pressure, machine helps those suffering from sleep conditions. Although CPAP machines have aided countless people with sleep apnea, insurance companies have been found to overcharge patients for the machine and its supplies.
If you or a loved one were diagnosed with sleep apnea and experienced overcharge fees from your insurance company, contact a CPAP machine lawyer. Attorneys who have the knowledge and experience in handling mass tort cases can help you seek the justice you deserve.
Sleep apnea is a condition where an individual’s airways become blocked throughout the duration of sleep. It can reduce or completely stop airflow, which can cause a person to stop breathing. A CPAP machine is intended to deliver air pressure consistently to the airways. In order to conclude if an individual has sleep apnea, a sleep study can be conducted.
Some common signs of sleep apnea include snoring, tiredness, mood swings due to lack of sleep, and breaks or pauses in breathing while asleep.
If this medical condition goes untreated, it can increase a person’s chances of high blood pressure, diabetes, headaches, and other health problems.
The CPAP machine has become increasingly common over the years, as more patients struggle with sleep apnea.
However, patients that use this device are usually unaware that insurance companies tend to charge higher fees than the actual cost of the equipment. Also, many people don’t know that their personal data is often collected and shared with other parties involved.
How Insurance Companies Overcharge CPAP Machines
In countless cases, insurance companies require their patients to rent the machine and pay rental fees, rather than paying for the machine itself. Rental fees, oftentimes, cost more than the machine’s retail cost.
A New Jersey resident, Alan Levy, had an insurance policy with Health Republic Insurance back in 2015. However, when prescribed the CPAP machine, Home Medical, the manufacturing company, required that he rent the device for 15 months at $104 a month. He was unable to have the device covered under his plan since his deductible was $5,000.
Levy researched the machine online and discovered that its actual cost was only $500, but Home Medical told him the total cost was $2,400. He refused to pay the outrageous cost. Instead, Levy filed a lawsuit against Home Medical, which reduced the price of the machine to $600.
Numerous patients who use the CPAP machine have paid more in rental fees than the retail price of the device. Also, many users have found that additional equipment for the machine, such as a new mask, hoses, or filters, are cheaper without insurance.
Are Privacy Laws Breached Through Data Sharing?
Some CPAP machine users feel uneasy about the idea of their personal data being shared among other parties. Data from your CPAP machine may be shared with your doctor, your insurance company, and even with the manufacturer.
The data collected by the CPAP machine allows insurance companies to track how frequently the patient is using the machine. If the data collected shows that the patient is not using the machine at a certain rate, it’s not uncommon for the insurance company to deny paying for supplies.
While many users are uncomfortable with their information being shared, “privacy experts say that sharing the data with insurance companies is allowed under federal privacy laws,” according to an article by NPR.
Surveillance Information Used by Insurance Companies
CPAP machines have the capability to collect data from the user, however, consumers are finding out that their information may be used against them.
Eric Umansky, an Editor at ProPublica, suffered from sleep apnea and was prescribed a machine. When the new mask failed to come in the mail for his machine, he called the company Advanced Oxy-Med, a supplier that was approved by his insurance company. The customer service representative told Umansky that his insurer may not pay for the mask required for his machine because he didn’t use the machine enough. He discovered that the insurance company was collecting data from his machine.
“You view it as a device that is yours and is serving you,” Umansky said. “And suddenly you realize it is a surveillance device being used by your health insurance company to limit your access to health care.”
Many Americans have experienced insurance denials for new supplies for their CPAP machines because of the data collected and reviewed by their insurance company. For example, if you are required to use the machine a certain amount of time each day, but fail to comply with those expectations, your insurance company may refuse to pay for new supplies. Although some insurance companies solely use the data collected to verify whether or not a patient is using the machine, other companies may use the data for other means.
“I wish they would spend as much time providing me care as they do monitoring whether I’m compliant,’” Umansky mentioned.
Contact an Attorney for Legal Advice
At Jim Glaser Law, we know that insurance companies seek their own interests and their ultimate goal is to make a profit.
If you or a loved one has been diagnosed with sleep apnea and experienced overcharge fees or insurance denials from the data they collected from your machine, you may be eligible to receive compensation.
CPAP machines and supplies can be costly, but when the insurance company has overcharged you for equipment fees, it is not fair.
Jim Glaser has assisted CPAP cases and can help you seek the justice you deserve. You can trust that your case will be carefully reviewed to determine your legal options. Please don’t hesitate to give our law office a call today at (480) 898-4816 or fill out our free consultation form.
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