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.