Independent Sleep Practice (ISP) Fact Sheet

What is Independent Sleep Practice Accreditation?

Independent sleep practice(s) are defined as an independent physician practice or a multi physician group that manage patients with all sleep disorders and conducts diagnostic testing through the use of Home Sleep Apnea Test (HSAT) only; an independent sleep practice does not have a lab for in-center sleep testing.
By meeting the ISP Standards for Accreditation, sleep practices accredited by the AASM are accredited for HSAT.

  • ISP accreditation is not intended for HSAT equipment suppliers that do not have a clinic where patient management is performed.
  • ISP accreditation is not intended for national patient management companies with the intent of supplying HSAT services/equipment to several or all states.
  • ISP accreditation replaced HSAT Standalone accreditation and is not appropriate for HSAT companies that contract outside physicians for clinical services.

Requirements of ISP Accreditation

Qualifications of Principal Medical Staff Member
Practice must designate a principal medical staff member who is an unrestricted licensed physician in the state where the practice is located and meets one of the following criteria:

  • Board certified in sleep medicine by ABSM, AOA, ABMS.
  • Physician who completed a 12-month ACGME accredited or AOA accredited fellowship in sleep medicine and is eligible to sit for and is awaiting first opportunity to apply to sit for the next available sleep board examination. Examination must be passed within two examination cycles.

Medical Staff Member Responsibilities

  • Medical staff members include physicians, licensed psychologists, APRN (all of whom may or may not be board-certified in sleep medicine) and physician assistants who hold a valid, unrestricted state license in states where patients are evaluated, diagnosed or treated. The AASM recommends medical staff members be board certified in sleep medicine.
  • May review information provided for directly referred patients and determine if they meet the criteria for the requested test.
  • Provides consultation, management, treatment and follow up assessment.
  • Provides the diagnosis of a medical condition as a licensed physician or APRN (allowed under the appropriate scope of practice in certain states). Diagnosis must be reviewed by an individual on staff that is board-certified in sleep medicine.

Patient Management

  • Standard G-1 requires the program to document in the medical record ongoing evaluation, management, and follow-up of each patient with sleep disorders.
  • The ISP program must demonstrate management of an adequate range of sleep disorders, such as insomnia, narcolepsy or other sleep disorders included in the International Classification of Sleep Disorders. Medical records must be available at the site visit for verification.
  • Patients prescribed PAP treatment by the practice’s medical staff members must be offered a follow-up positive airway pressure (PAP) assessment within 12 weeks of treatment initiation.
  • An ISP must demonstrate, in writing, an existing relationship with an accessible AASM-accredited facility that can provide full diagnostic sleep testing in a laboratory when needed for the continued management of practice patients.

Quality Assurance

  • The principal medical staff member must review, report, and manage the practice’s quality assurance program on a quarterly basis as mandated in Section J of the Standards.
  • The practice must have a QA program for HSAT that address two process measures and one outcome measure.
  • The practice must establish minimal thresholds for the quality assurance metrics.

Key Things to Keep in Mind

  • An ISP is a physician(s) practice that sees, treats, and manages patients of all sleep disorders, performs sleep clinic, and then utilizes HSAT to provide diagnostic testing to further evaluate and treat those patients.
  • ISP accreditation is not intended for HSAT equipment suppliers (local or national) that do not have a clinic where patient management is performed.
  • Patients that are directly referred must be evaluated for appropriateness of HSAT testing based on history, physical and medical notes.
  • Quality assurance should apply to all patients the sleep program manages. Quality assurance excludes direct referral testing.