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CALL TO ACTION:
SUPPORT HR 3790 to Repeal the Medicare Competitive Bidding Program!
Support CAMPS Legal Fight of UBL! |
| 50% of Oxygen Providers gone in
Miami-Dade, LA & other counties
Rob Brant, President of the Accredited Medical Equipment Providers of America (AMEPA)
The cost of maintaining accreditation, surety bonds and licensed Respiratory Therapist, combined with cuts in reimbursements and caps in monthly payments have finally caught up with oxygen providers. According to Medicare's website, in Los Angeles County, CA there are only 120 oxygen providers remaining, compared to the 258 which existed in April 2008. During the same time, Miami-Dade County, FL oxygen providers dropped from 401 to 205.
Riverside County had a 56% drop in oxygen providers, the largest in Southern California. Last year there were 48 oxygen providers and today only 21 providers are left to cover the 7,200 square mile area.
A steady decline
AMEPA has watched a steady decline in providers, which began in April, 4 months after the implementation of the 9.5% cut in reimbursement to delay the flawed DMEPOS bidding program. The 36 month cap in monthly oxygen payments also began in January, 2009. Owners of licensed oxygen companies, which recently closed, noted that the requirement to continue to provide monthly service and supplies, upgrade equipment and cover all oxygen needs when a patient travels out of the area, without additional reimbursement from Medicare compounded the inability to stay in business.
In early September, AMEPA reported a 30% drop of Oxygen Providers in Miami-Dade County, since last year. The January reimbursement cuts and 36 month cap was already taking affect, but the October 2009 Medicare requirements of mandatory accreditation and minimum $50,000 surety bond is credited for causing another large drop in providers.
"We have been warning legislators about this for the last 9 months" said Roger Ribas, President of the Florida Alliance of Home Care Services (FAHCS). "The costs of the new quality assurance measures combined with the 2009 payment restrictions, make it nearly impossible for licensed oxygen providers to provide quality equipment and timely services to patients. The elderly and those with respiratory ailments are the ones who are going to suffer, after their oxygen providers go out of business. The remaining oxygen providers cannot afford, and are not required to take on the obligations of servicing someone else's oxygen patient, for free, after the patient has had an oxygen system beyond 36 months."
Rural Areas Affected
Large metropolitan areas were not the only ones to lose oxygen providers. The rural counties of Leavenworth, KS and Hunt, TX have both seen a 50% drop in providers. Both counties previously had 10 providers, now only 5 remain in each county.
"It becomes a safety issue when a community relies on only 5 oxygen providers to service an area nearly 900 square miles in size", said Barry Johnson, CRT, President of the Texas Alliance of Home Care Services (TAHCS)
"There is only one major highway and one small medical center in Hunt. With the limited number of providers, Medicare beneficiaries' access to care would be severely impacted when tornadoes, ice storms or power outages occur. It would create a life threatening situation for many patients who require life sustaining oxygen."
Bubble Bursting in the DME Industry
It is hard to believe that even though half of the oxygen providers are out of the Medicare program in these areas, the DMEPOS bidding program will still move forward. The program's goals of limiting providers and reducing reimbursement have clearly been achieved. Legislators must be asked the question:
"Can Medicare suppliers take more unrealistic cuts proposed by the same flawed bidding program, when so many businesses are struggling to stay open to provide patient care at home?"
In the last year we have seen the bubble burst in the housing and banking industries. The 26 supplier standards, ongoing physician documentation, accreditation, liability insurance requirements, billing requirements, credentialed employees and proper care and maintenance of a Medicare patient is an expensive proposition for any licensed and bonded provider.
The removal of such a significant portion of oxygen providers from the Medicare program should be evidence enough that there is more to providing for Medicare patients than the manufacturers cost of a piece of home medical equipment. When the bubble bursts in the home medical equipment industry, it will be up to the doctors and hospitals to care for the oxygen needs of seniors and the disabled, at a much greater cost to Medicare than the current DMEPOS system.
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Update on HR 3790 - Budget Neutral Repeal of DMEPOS Bidding
The bill has at least 34 co-sponsors including:
California
Rep. Sam Farr (D)
Colorado
Rep. Betsy Markey (D)
Florida
Rep. Lincoln Diaz-Balart (R)
Rep. Alcee Hastings (D)
Rep. Ron Klein (D)
Rep. Bill Posey (R)
Rep. Debbie Wasserman-Schultz (D)
Rep. Robert Wexler (D)
Georgia
Rep. John Barrow (D)
Iowa
Rep. Bruce Braley (D)
Rep. David Loesback (
Maine
Rep. Michael Michaud (D)
Massachusetts
Rep. Barney Frank (D)
Michigan
Rep. Candice Miller (R)
Missouri
Rep. Jo Ann Emerson (R)
New Jersey
Rep. Frank LoBiondo (R)
New York
Rep. Dan Maffei (D)
North Carolina
Rep. Larry Kissel (
Mike McIntyre (
Rep. Heath Shuler (D)
Ohio
Rep. Steve Austria (R)
Rep. John Boccieri (D)
Rep. Marcia Fudge (D)
Rep. Tim Ryan (D)
Rep. Pat Tiberi (R)
Rep. Michael Turner (R)
Pennsylvania
Rep. Jason Altmire (D)
Rep. John Murtha (D)
Rep. Glenn Thompson (R)
Texas
Rep. Ralph Hall (R)
Rep. Eddie Bernice Johnson (D)
Virginia
Rep. Thomas Perriello (D)
Rep. Robert Wittman (R)
Please take a few minutes to Fax your U.S. Representative We really need some more momentum. If your legislator is not listed above then please take a few minutes to do the following:
1) Look up your U.S. Representative at www.congress.gov
- simply enter your zip code of your home and each office location to find your U.S. Congressman/woman
2) Fill out a fax cover page addressed to: "Health LA" for each of your representatives and note:
"Please co-sponsor HR 3790, a bi-partisan budget neutral repeal of the flawed DMEPOS Bidding Program. This bill will give congress the same savings that the program was projected to give, without unnecessarily eliminating 90% of the local providers and without limiting a patient's access to quality products and timely services. The bidding has already begun and we need support as quickly as possible."
3) Print out the linked page below and fax to their local and Washington, DC offices.
Click to view HR-3790 summary page to fax.
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CAMPS Needs Your Suport on the Upper Billing Limit Regulation Litigation
We previously informed you that the CAMPS Board authorized our outside counsel to file an appeal of the decision in our Writ of Mandate effort to repeal the Upper Billing Limit regulation that governs the Medi-Cal program. That regulation in effect since 2004 prohibits a Medi-Cal provider form billing more then 100% more then the "net purchase price" for dme and medical supplies. There is a statement in a recent Medi-Cal Bulletin indicating the Department's understanding that the UBL also applies to enteral formula.
Our challenge to the legality of the regulation was rejected in Alameda Superior Court and on October 2nd we filed a notice of appeal with the Court of Appeal. It will be several months before briefs are filed and oral argument occurs. We would not anticipate a decision until summer of 2010.
CAMPS has expended all of the funds contributed by members to the Legal Fund and dipped into reserves to pursue the initial phase of the litigation. We are seeking your financial support. If you've contributed already we thank you and ask you to consider another contribution to the Legal Fund. Financial help is needed to help us pursue this appeal.
Make your contribution today. Click here to access the donation form.
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CAMPS Calendar of Events
March 2-3, 2010
CAMPS Annual Convention
Hilton Irvine/Orange County Airport
Room Rate $159
Reservations: 800-445-8667, ask for CAMPS special rate
March 4, 2010
CAMPS Board Meeting
Hilton Irvine/Orange County Airport
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The California HME Update is a benefit provided to members of the California Association of Medical Product Suppliers (CAMPS). It is published periodically to keep members informed of issues affecting the Home Medical Equipment (HME) industry. Inquiries should be addressed to Gloria Peterson at the CAMPS office by phone at (916) 443-2115 or e-mail at gpeterson@amgroup.us.
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