Below is a speech delivered by Robert Brant, owner of City Medical Services in North Miami Beach, Florida and President of AMEPA. He attended the Program Advisory and Oversight Committee (PAOC) Meeting in Baltimore, Maryland yesterday, where all aspects of the initial implementation of Medicare's Bidding Program were discussed.

His speech was the clearest delivery of the message that contract awardees and non awardees understand, the program created is restricting patient access, killing companies and is unsustainable.

Good Afternoon,

My name is Robert Brant and I am the co-owner of City Medical Services in North Miami Beach, Florida in the Miami CBA. My business began in 1997 and we were Joint Commission accredited, nine years before it was required.

In July, I accepted the contract as a bid winner for Oxygen in the Miami CBA, even though I was not awarded contracts in other areas I am experienced and bid in: Hospital Beds, CPAP and Respiratory Assist Devices, Walkers, Enteral Tube Feeding Supplies and Support Surfaces.

Last week I decided to close my business after a call from an oxygen patient, Jean.

Jean requires continuous oxygen and uses an average of 6 large tanks a week. The previous portable oxygen rate was $28.77 per month for suppliers to provide as many oxygen tanks as the patient needs. I did not bid a penny below that number because I did not want to violate the "Bona Fide Bid" requirement. That is the program's guarantee that bids are not accepted below the manufacturer's cost.

I can't even make one trip to the patient's home, honk my horn and drive away for $28.77, let alone the bid rate of $21.66 per month and provide an average of 24 oxygen tanks per month to Jean; and she called to tell me that she needed more tanks.

Over the last few years, because of cuts in reimbursement, cuts in the total number of months paid, new compliance regulations and increased documentation requirements, our annual revenue has dropped from one million dollars per year to $600,000 in 2010.

In preparing for life under competitive bidding, I laid off half of my staff and reduced my physical space. Unable to continue to supply CPAP disposables, Enteral Feed Supplies, Diabetic Supplies and a $50 cut in monthly oxygen reimbursement, our company will lose $25,000 in revenue per month, a total of $300,000 for 2011.

It is impossible for me to operate my business, pay for rent, vehicles, a licensed respiratory therapist and other staff under this model and still take care of Jean and the hundreds of other patients like her.

In order to cut my losses and stop incurring debt, I have decided to close my business, effective April 30th.

The one flaw in this program that angers me more than any other is the fact that in January, I tried to send over 150 existing CPAP patients to a local bid winner. This bid winner was not one of the many located out of state or hundreds of miles away in Central Florida. This company is located about 10 miles from my office and they refused to provide new CPAP masks to my existing patients.

They explained to me that they have never provided CPAP devices or supplies before and they were not about to start. The fact that I was not awarded a contract and yet out of state, out of area, inexperienced and financially bankrupt companies were awarded contracts is very difficult to accept and I pray that this program is stopped before more patients and more companies are affected.

Thank you,

Robert Brant

After Robert Brant spoke, Dr. Cramton, the economist who hosted the conference last Friday, spoke about the Bidding Program and its fundamental flaws.

Dr. Cramton chastised CMS for its lack of proper scientific methods and how the irreversible errors were do to CMS' decision not to consult with experts. Dr. Cramton said "If you are going to build a bridge, you will consult a structural engineer, and if you have a skin condition you would consult with a Dermatologist, but CMS wanted to build an auction program but they never consulted an auction expert."

He continued by saying "No economist in the world would say this program can work the way it was designed". Dr. Cramton's points were very strong and were heeded by the Committee.

It seemed though that the PAOC was and is unable to act. Jim Tozi of the civic action group CRE spoke as well, he said that the PAOC could not act because they have never been given the proper financial guidelines.

CMS' opinion of its program is very high. CMS has spent the day stating that the program is nearly flawless and attempted to prove its' near perfection. Despite the fact that the comments of experts and business owners at the end of the day seemed to counter everything CMS said, CMS will not change its' plans, unless forced by Congress.

It is once again up to the education we provide our elected leaders, in order to stop this program.

Below is a speech delivered by Robert Brant, owner of City Medical Services in North Miami Beach, Florida and President of AMEPA. He attended the Program Advisory and Oversight Committee (PAOC) Meeting in Baltimore, Maryland yesterday, where all aspects of the initial implementation of Medicare's Bidding Program were discussed.

His speech was the clearest delivery of the message that contract awardees and non awardees understand, the program created is restricting patient access, killing companies and is unsustainable.

Good Afternoon,

My name is Robert Brant and I am the co-owner of City Medical Services in North Miami Beach, Florida in the Miami CBA. My business began in 1997 and we were Joint Commission accredited, nine years before it was required.

In July, I accepted the contract as a bid winner for Oxygen in the Miami CBA, even though I was not awarded contracts in other areas I am experienced and bid in: Hospital Beds, CPAP and Respiratory Assist Devices, Walkers, Enteral Tube Feeding Supplies and Support Surfaces.

Last week I decided to close my business after a call from an oxygen patient, Jean.

Jean requires continuous oxygen and uses an average of 6 large tanks a week. The previous portable oxygen rate was $28.77 per month for suppliers to provide as many oxygen tanks as the patient needs. I did not bid a penny below that number because I did not want to violate the "Bona Fide Bid" requirement. That is the program's guarantee that bids are not accepted below the manufacturer's cost.

I can't even make one trip to the patient's home, honk my horn and drive away for $28.77, let alone the bid rate of $21.66 per month and provide an average of 24 oxygen tanks per month to Jean; and she called to tell me that she needed more tanks.

Over the last few years, because of cuts in reimbursement, cuts in the total number of months paid, new compliance regulations and increased documentation requirements, our annual revenue has dropped from one million dollars per year to $600,000 in 2010.

In preparing for life under competitive bidding, I laid off half of my staff and reduced my physical space. Unable to continue to supply CPAP disposables, Enteral Feed Supplies, Diabetic Supplies and a $50 cut in monthly oxygen reimbursement, our company will lose $25,000 in revenue per month, a total of $300,000 for 2011.

It is impossible for me to operate my business, pay for rent, vehicles, a licensed respiratory therapist and other staff under this model and still take care of Jean and the hundreds of other patients like her.

In order to cut my losses and stop incurring debt, I have decided to close my business, effective April 30th.

The one flaw in this program that angers me more than any other is the fact that in January, I tried to send over 150 existing CPAP patients to a local bid winner. This bid winner was not one of the many located out of state or hundreds of miles away in Central Florida. This company is located about 10 miles from my office and they refused to provide new CPAP masks to my existing patients.

They explained to me that they have never provided CPAP devices or supplies before and they were not about to start. The fact that I was not awarded a contract and yet out of state, out of area, inexperienced and financially bankrupt companies were awarded contracts is very difficult to accept and I pray that this program is stopped before more patients and more companies are affected.

Thank you,

Robert Brant

After Robert Brant spoke, Dr. Cramton, the economist who hosted the conference last Friday, spoke about the Bidding Program and its fundamental flaws.

Dr. Cramton chastised CMS for its lack of proper scientific methods and how the irreversible errors were do to CMS' decision not to consult with experts. Dr. Cramton said "If you are going to build a bridge, you will consult a structural engineer, and if you have a skin condition you would consult with a Dermatologist, but CMS wanted to build an auction program but they never consulted an auction expert."

He continued by saying "No economist in the world would say this program can work the way it was designed". Dr. Cramton's points were very strong and were heeded by the Committee.

It seemed though that the PAOC was and is unable to act. Jim Tozi of the civic action group CRE spoke as well, he said that the PAOC could not act because they have never been given the proper financial guidelines.

CMS' opinion of its program is very high. CMS has spent the day stating that the program is nearly flawless and attempted to prove its' near perfection. Despite the fact that the comments of experts and business owners at the end of the day seemed to counter everything CMS said, CMS will not change its' plans, unless forced by Congress.

It is once again up to the education we provide our elected leaders, in order to stop this program.