'It's just piling up' in Maryland

ANNAPOLIS, Md. - If you're an HME provider in Maryland, the new payment amounts for Round 2 of competitive bidding are merely one piece of bad news you're dealing with right now.

The others: Starting this year, providers have to pay $3,000 in DME licensing fees every three years instead of $500 every year; they must also pay pharmacy licensing fees of $700 per year for the first year and $600 every year thereafter; and, as of press time in early March, they may have to have a full-time pharmacist on staff.

“It's a quadruple threat,” said Ann Horton, the executive director of the Maryland National Capital Homecare Association (MNCHA). “It's just piling up.”

While the new licensing fees are pretty much a done deal, the association has appealed, through the legislative process, to make them effective in 2014 instead of 2013, so providers have time to better budget for them.

As for having a full-time pharmacist on staff: There's an emergency bill in the state legislature, backed by the Maryland Pharmacy Board, to exempt HME providers from the rule. But the bill must be passed by April 8, when the legislature closes up shop.

“If it does not pass, many will be immediately non-compliant,” Horton said.

Things get even more complicated when you consider the implications of the rule on providers who submitted bids for Round 2 of competitive bidding. Providers must comply with all state licensure requirements to participate in the program. Pre-competitive bidding, the rule wasn't an issue (providers who inquired were told by the board not to worry about it); post-competitive bidding, it may very well be.

“As far as we know, no one else is keeping track of the big picture here,” Horton said. “None of these things are coordinated.”

Provider Jim Steele thinks common sense will win out in the end (“It's insane to put that kind of cost on a provider of, say, CPAP supplies,” he says), but if it doesn't, he and most other providers are in big trouble.

“If we don't get that bill passed, I don't know how we're going to function,” said Steele, executive director of Better Life Home Medical in Brandywine, Md., and treasurer of MNCHA.