Re: Competitive Bidding, Surety Bonds and 36 Month Cap on Oxygen

I am a sole proprietor and have been in the DME business and a Medicare Provider for over
24 years. I am a small business owner (8 employees) in the Sierra Nevada mountain range in California. Yosemite National Park is part of my service area. I have Medicare Customers scattered all through these mountains. It’s normal for my drivers to put 200 to 300 miles a day of mountain driving to service Medicare Patients with their medical equipment needs. Like the Post Office we deliver / service thru “rain, hail, sleet and snow,” but ours is 24 hours a day 7 days a week.

I have spent the time and money becoming Accreditated with JCAHO. I have all the licenses that are required by law and have tried to follow the industry standards to the best of my ability. I have never had to submit a claim to my insurance company over the last 24+ years! Yet now I’m told I am going to be required to get a “Surety Bond”. Why? Shouldn’t that happen only to those who have been a problem like “The Scooter Store?” I have survived the many cut backs and changes that have happened in the Medicare realm over the last 24 + years. I also know with this experience that when Medicare speaks all other insurance companies follow. So this change will also affect my relationship with most of the other insurance companies I do business with.

In saying this, I believe the “Competitive Bidding” program that has been developed by Medicare is not in the best interest of small businesses or Medicare Patients. How could it be when 1,000’s of small businesses as myself will be unable to compete with companies like “The Scooter Store”, who has done nothing but break rule after Medicare rule and even had to pay millions of dollars back to Medicare for “fraudulent claims” (without having to admit quilt) and still retains their “Provider” status! How can we small DME businesses compete with that? What will my patients do when we close and they have to drive an extra 80+ miles round trip to the next DME company? Mountain and rural people will suffer greatly from this form of Competitive Bidding.

I believe all existing DME companies that are Medicare Providers should be able to continue billing at the rate that is decided by whatever means. That is fair!

Honestly, I never thought Competitive Bidding or the 36 month oxygen cap would go this far! Whoever thought up the 36 month oxygen cap was NOT a business person! I believe the price for oxygen use should have been divided up over the 60 month life of a concentrator but this figure must also include service, supplies and the 24 hour emergency service that comes with it! I don’t know one business person that would want to get paid for 36 months rental of a piece of high tech equipment then receive practically nothing for 24 months more! Not only that, if the patient moves across the country the DME company has to pay another company to provide the patient with oxygen for up to 24 months! My business brain tweaks out every time I think of it! It is not logical or good business. The fact is the cost to keep a patient at home with DME and/or Home Oxygen is so small compared to any hospital stay! We are already a discount industry when compared to many other medical expenses.

Please keep small companies like mine in mind when you make your decisions. We have been here for Medicare Patients for 24 loyal years. If I were to lose my Provider status with Medicare I would go out of business! For my Employees, my Medicare Customers and my Business I appeal to your conscience.

Thank you for your time and may the decision be what is best for the “quality of life” and the “independence for daily living” of our Medicare Patients and for the life of the Small DME Businesses scatter throughout this nation.

Paula Henry

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