Small providers: 'Fearful of losing their businesses'

Sunday, May 27, 2007

MIAMI - A Miami provider has orchestrated another effort to take the air out of national competitive bidding.

At "emergency" meetings May 10 in Miami and last week in Orlando, Fla., City Medical Services urged providers to file complaints with the Small Business Administration, arguing the program fails to meet a Congressional mandate to protect small providers. Their hope: The SBA will intervene and stop or delay the program.

"We're trying to get as many complaints filed with the ombudsman as possible," said Rob Brant, co-owner of City Medical, part of the Miami competitive bidding area (CBA). "We're also asking providers to send letters to CMS and their representatives. If nothing happens in the next few weeks, we'll formulate a lawsuit."

More than 60 providers and other industry stakeholders attended each of the meetings.

In a final rule released earlier this year, CMS established a 30% "small supplier participation target" for each CBA. But "after doing the math," Brant realized City Medical has only about a 1.5% chance of becoming a winning bidder for oxygen in the Miami CBA.

(According to Brant: There are about 450 oxygen providers in the Miami CBA. Since CMS estimates 90% of all providers have charges of $1 million or less, that means 405 of those providers are small providers. Twenty providers will probably win bids in each product category, a Medicare official told City Medical; six of those providers must be small providers. With 405 providers vying for those six spots, that means each provider has a 1.5% chance of becoming one of the winning bidders.)

"You have all these small providers spending $10,000 to get accredited and 98% to 99% of them will no longer be able to do business with Medicare," Brant said. "Are they scrambling for nothing?"

While the Tanner-Hobson bill includes an "any willing provider" provision that would go a long way in protecting all providers, Eileen Salem, owner of Active Mobility & Respiratory Center, part of the Orlando CBA, said providers can't rely on the bill passing.

"So far, only 20-something representatives have signed onto the bill; last year, we had close to 90," said Salem, who helped organize the meeting in Orlando. "Even if the bill goes through and we can still provide equipment, we don't know what the winning bid will be."

While she believes in the Tanner-Hobson bill, Joan Cross, director of operations for C&C Homecare in Bradenton, Fla., said, "I value any concept that could be a possibility."

Cross attended the Orlando meeting, not because she's in the Miami or Orlando CBAs, but because she wanted to lend her support.

"There was a whole lot less anger and a lot more fear than I thought there would be," she said. "These people are fearful of losing their businesses. It's sad."