Florida Provider Hopes to Marshal Small HMEs

MIAMI–After reading the 401-page final rule on competitive
bidding, Rob Brant, general manager of City Medical Services in
North Miami Beach, Fla., decided it was time to take matters into
his own hands.

“I don’t want to call out any associations or organizations,”
said Brant, “but when I spoke to some of them at Medtrade [Spring],
they made me feel that the businesses in the 10 competitive bidding
areas are the poster children for competitive bidding, and they are
just sitting on the sidelines waiting for disaster so when it comes
around again to the next [70 MSAs], they can say, ‘Look what
happened in South Florida with all the companies that went out of
business. We don’t want that to happen in New York or Chicago.’

“That’s all very good for them, but this is my business, this is
my livelihood, and I’m not going to go down without a fight.”

A 10-year-old HME that’s been accredited for seven of those,
City Medical qualifies as a “small supplier” under CMS’ final rule
definition, which classifies them as generating total revenues of
$3.5 million or less. The rule sets a 30 percent target for winning
bid contracts to be awarded to small suppliers.

While CMS is “throwing us a bone” with its 30-percent
“set-aside” for small business, Brant said, “it’s not 30 percent of
business, it’s not 30 percent of businesses, it’s not 30 percent of
bidders–it’s 30 percent of winners.” That means, he continued, “if
you look at what’s actually going to happen, if there are 10 to 20
winners, then 30 percent of that is only three to six small
businesses … If there are only seven winners, then 30 percent of
seven is two small businesses. It’s very scary.”

In a notice sent last week to accredited providers in the Miami
area, Brant has called an emergency meeting “to consider possible
action concerning the anticipated elimination in April 2008 of 98
percent to 99 percent of all ‘small suppliers’ currently doing
business with Medicare … the final rules on competitive bidding
confirm that the methodology for awarding bids will result in a
virtual wipe-out of all small suppliers in the South Florida CBA
(Miami-Dade, Broward, Palm Beach MSA) as well as every other CBA in
the country.”

“I’ve had my customer service staff calling all of the
accredited providers, and I’ve sent the notice to billing companies
to send out. We’ve also gotten help from some of the local
manufacturers’ reps in spreading the word” about the meeting, Brant
said, adding that his company had been told that CMS had not
received any complaints about its small supplier target.

“Some estimates say 90 percent of all the DME business in the
country is done by small businesses,” Brant said. “If CMS hasn’t
received any complaints, then for me, for my employees, I’m going
to let other companies know there’s a problem. It’s time to say
‘Look, you say you haven’t heard any complaints, we’re going to be
sending you some,” he said.

“It’s up to these companies to stop sitting on the sidelines and
saying ‘I pay my dues to VGM or AAHomecare and I’m sure they’ll
come up with something.’ I’ve got to save my livelihood … it’s
me, it’s my wife, it’s my kids, it’s my employees, it’s their
families, it’s their health care plans and their salaries and
raises they have earned over the years.”

At the meeting, where he hopes to see a minimum of 100 companies
represented, “I’m going to be looking for ideas and action,” Brant
said. “My agenda is really simple: I want to save my business.”

The meeting is scheduled on Thursday, May 10, at 7:00 p.m. at
the Holiday Inn at 2905 Sheridan Street, Hollywood, Fla. For more
information, contact Brant at [email protected].