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 rob@citymedical.com.