Since a decree of October 22, patients who benefit from a continuous positive airway pressure (CPAP) device to treat their sleep apnea must be required to wear this mask at least 3 hours per night and 20 days per month, s ‘they want to be reimbursed by social security. And to be sure that they are following the treatment, all are monitored by remote monitoring (a remote monitoring system transmits the data to Health Insurance and to the attending physician). This systematic remote compliance, coupled with conditional reimbursement, was to concern all patients by 2016, i.e. some 500,000 people.
This decision, taken jointly by the Ministry of Health and the Ministry of the Budget, has been talked about a lot since October, especially among patient associations who considered this decree medically too questionable and therefore followed it. attacked before the Council of State.
The latter rendered his decision today: in his order, the judge suspended the decree, considering that there is a “serious doubt” on the competence of the government to set up such a mechanism and also considering that ‘There was an emergency because many patients risked being delisted from next June.
Sleep apnea: the order of the Council of State
“On the one hand, the summary judge noted that the contested decree makes the coverage of the CPAP treatment in particular dependent on the effective observation, by each patient, of the conditions of use set by the decree and provides that the control is based on the automatic transmission of data of daily use of the device by the patient. He deduced that there is, in the state of the investigation, a serious doubt on the competence of the ministers in charge of health and the budget to enact by decree such a mechanism.
On the other hand, the summary judge noted that several tens of thousands of patients already fall under the new regime put in place by this decree, which has been mandatory for new patients since October 1, 2013, and that these patients are thus susceptible , if they do not respect the conditions of daily use of their device, to be deprived, from the month of June, of any reimbursement for a minimum period of 26 weeks. He deduced that there was an emergency situation.
The two conditions set by the code of administrative justice (urgency and serious doubt about legality) having been met, the summary judge suspended the execution of the decree, ”the Council of State wrote in its press release.
