MIAMI--A Miami HME provider who appealed to the Small Business Administration for help in fighting competitive bidding said last week he is giving up on getting any support from that agency.
Rob Brant of City Medical Services in North Miami Beach said that he and other providers involved in the effort are now striving to generate support for H.R. 1845, the Tanner-Hobson bill, which would allow qualified providers who do not win a bid to continue to do Medicare business under the new competitive bidding rates.
"There is no place to go with the SBA," said Brant, who earlier this year mustered the support of more than 70 other small Florida providers and filed a formal complaint with the SBA ombudsman against the implementation of competitive bidding. The complaint charged that "CMS improperly interpreted the congressional mandate and did not provide the appropriate protection of small suppliers." (See HomeCare Monday, May 22.)
The agency has responded with form letters, including one from CMS, Brant said. "They say the complaint is unfounded, that it's fair for everyone," he said.
So Brant and his peers are taking another tack.
"We've been very focused on visiting congressmen and women about Tanner-Hobson and getting the word out to our patients about [the bill] and giving patients the toll-free switchboard line to Congress to say we are not happy about what is happening," Brant said.
"In every state where there is competitive bidding, I think every congressperson should sign on to Tanner-Hobson," he added. The bill has picked up 130 cosponsors, but needs more to move forward.
Like other HME providers in the first 10 cities where the bidding program is being implemented, Brant, who did bid, is in a holding pattern until the winners are chosen and the new allowables are revealed by CMS. Bid winners will be announced in March or April of 2008, the agency said at a recent meeting of the Program Advisory and Oversight Committee. The resulting reimbursements are set to take effect in July.
"We are just waiting to see what the allowables will be compared to other areas," Brant said. "Right now, we are trying to do as much business as we can while we still can."
Already, though, he is seeing an impact from competitive bidding. Some smaller providers have closed down, Brant said, and whether his company wins a bid or not, he anticipates big reimbursement cuts. So he is looking everywhere for business economies, even at service. "We used to visit patients every week. We can't do it anymore. We've told about three patients a month that we can't service them the way they are used to being serviced," he said.
Brant recognizes, he said, that the providers in the first round of MSAs are essentially guinea pigs. "The next 70 MSAs will benefit so much from the knowledge of what happens to us," he said. "They are having time to get accredited, trim the fat, gobble up the customers from businesses that are closing."
Still, he is hopeful that Tanner-Hobson will eventually pass and competitive bidding's impact can at least be blunted.
"We're going to keep plugging away and do what we can," Brant said. "We have eight months left 'til the end of the world."