AMEPA Members File SBA Complaint

MIAMI — Board members of the Accredited Medical Equipment
Providers of America filed a complaint about CMS’ new oxygen
regulations with the Small Business Administration through their own
companies Thursday. The complaint is based on the fact that CMS did
not comply with the Regulatory Flexibility Act in issuing the
rules, which “will likely bankrupt many small business oxygen
providers,” AMEPA said in a statement.

Included as part of Medicare’s 1,459-page 2009 Physician Fee Schedule, the group said page 1033
of the massive document addresses the impact on small businesses.
However, the statement noted, the rule states “it is difficult to
estimate the impact of section 144(b) of the [Medicare Improvements
for Patients and Providers Act] on small entities and oxygen and
oxygen equipment suppliers in general. Nevertheless, we do believe
that the net impact on small entities and other suppliers of oxygen
and oxygen equipment will be positive rather than negative.”

The rule continues, “This is based on the fact that this change
allows suppliers to retain ownership of oxygen equipment in all
cases when it is no longer needed by the beneficiary. Prior to this
change, suppliers were required to relinquish ownership of oxygen
equipment after 36 continuous rental months.”

AMEPA President Robert Brant disagrees. “We have historical data
which proves that most oxygen concentrators are discarded after
three years of continued use because it is more expensive to have
the unit refurbished than purchase new ones,” he said.

“Having to send a technician to the patient’s home for routine
and non-routine maintenance and service, provide filters,
disposables and other supplies, as well as the cost to provide
equipment when the patient relocates for the next two years for
virtually no reimbursement will likely bankrupt most oxygen service
providers,” Brant added. “The cost is in the 24/7 service that we
provide. I do not see how obtaining an oxygen concentrator with
over 25,000 hours will make up for all of those costs.”

The providers’ SBA complaint also notes the requirement to
provide equipment and services when patients relocate “will have a
much greater impact on small providers than the nationals.”
According to Brant, “After the 36-month cap, a national company can
simply transfer a patient to another branch. In the case of the
small provider, I may have to pay an out-of-area provider near
Medicare rates on a monthly basis for another two years.”

AMEPA is encouraging oxygen providers with net revenues less
than $7 million annually to file a complaint with the SBA, and to
send it to their federal legislators.

The group supplied this link for filing a complaint.