Alabama: Sharp line divides providers

BIRMINGHAM, Ala. - The ink was barely dry on a new law making a brick-and-mortar location a requirement for licensure in Alabama when providers in neighboring states found themselves on the wrong side of the divide.

“I have a location in Columbus, Ga., that is separated from Phoenix City, Ala., by the Chattahoochee River—it's 1.6 miles from the state line,” said Tyler Riddle, president of MRS Homecare. “Now the state of Alabama tells me I can no longer get an Alabama license, which I have had for years.”

The law, which is slated to take effect Aug. 1, allows no exceptions, confirms provider Peter Czapla, who worked on the legislation and said it is similar to a law in Tennessee.

“There's nothing that anybody can do as far as exemptions for bordering counties,” said Czapla, co-owner of Quality Home Health Care in Wetumpka, Ala., and chairman of the State of Alabama Board of Home Medical Equipment, which issues licenses. “If there's an exemption for 10 miles, what about suppliers that are 11 miles away?”

Provider Carter Fuller has a location in Chattanooga, Tenn., which is also on the border with Alabama, and services patients in the state.

“If you're not opening a location in the state of Alabama, don't even think about it,” said Fuller, vice president of business development for Professional Medical & Respiratory. “Sometimes these things are overkill and you end up hurting patients because you exclude companies like us.”

Czapla says patient protection was top priority.

“We tried to create the best law to protect patients,” he said.

Riddle says he “wholeheartedly” supports licensure as a way to protect local providers from out-of-state bidders but says he's caught in an unintended consequence of the new law.

“I can't even service my patients,” he said.

Colorado also recently passed a law requiring a physical location, but it allows any provider within 50 miles of the border to be licensed in the state. There are not many providers in that radius, though, says Doug Coleman, president of the Colorado Association for Medical Equipment Suppliers (CAMES).

“It's not a big deal in Colorado,” he said. “Other states—it could be huge.”