The home medical equipment industry has been growing ever since it became clear that getting patients out of the hospital sooner would reduce overall health care costs. Home medical equipment companies provide the products that disabled, elderly and infirm people need in order to live independently. They deliver the equipment, train patients and caregivers in its use and repair or replace it when needed.

But in Maryland, a conflagration of regulatory events threatens to dismantle the industry.

On the federal side, a new cost saving program known as competitive bidding has been put in place for many medical equipment items. The new rates for Maryland were announced recently, and they will reduce the reimbursement to providers by an average on 45 percent.

A reduction in reimbursements for critical health care services for the disabled and elderly is unprecedented to my knowledge. In other areas of the country where competitive bidding has been implemented, providers have gone out of business in droves.

At the same time, Maryland has introduced additional changes that will increase the cost of the regulatory burden on home medical equipment providers. License costs are set to double from $500 per year to $1,000 annually, and must be paid in three-year increments. Moreover, a new interpretation of an old regulation will mean that all of these providers will now have to obtain a pharmacy license at the cost of $700 this year and $600 each year thereafter.

Thus in a year when the industry is taking a 45 percent cut in reimbursements, Maryland is demanding home medical equipment licensing fees of $3,700. A vital industry that has ensured that Marylanders can safely live in their homes despite physical and health challenges is being dismantled.

What this means is that we can bid farewell to the many local, small business and family-owned medical suppliers in Maryland that provide critically needed services to the elderly and the disabled. That is a sad commentary on our compassion for the needs of the most fragile members of society.

Ann Kirwan Horton

The writer is executive director of the Maryland-National Capital Homecare Association.

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