Dealers Discuss: Sandra Hoskin, President/CEO, American Medical Equipment Co.

Editors Note: In addition to running an HME company, Sandra Hoskin is the vice president of the Medical Equipment Suppliers Association (MESA), a regional association that joined together state associations in Arkansas, Louisiana, New Mexico, Oklahoma and Texas. For more information on MESA, visit

Describe your business.
We do concentrators, liquid, portables, CPAPs, BiPAPs, apnea monitors. I have one RT here in Houston, and I have two in Louisiana. We have a VA contract for the state of Louisiana for all of the home oxygen for veterans. I have three locations in Louisiana, but it’s strictly warehousing. We have a very large retail outlet. We’re in the midst of the Texas Medical Center here in Houston, which is the largest medical center in the country. We’re very fortunate to have a very prime piece of property.

How did you first become involved in MESA?
This goes back to 1984-85; it was TAMED (Texas association) at the time. Shortly after we went into business, someone called me and said that there was a local meeting for dealers. They were just having an open round table type of thing, and I went to that. I decided that I really needed to get into the organization and see what was going on.

How has belonging to a regional association helped your business?
Our prime goal with MESA is education and through all of the various educational programs that MESA has put on, with the two main conferences primarily, it certainly has kept us up to date and apprised of everything that’s going on and the best way to handle things.

What are some of the projects that your organization works on?
We have two main conferences a year, one in the spring and one in the fall. We always have a legal expert; we have several accreditation people in. Jane Bunch always comes in and does her basic billing. Clay Stribling from Brown & Fortunato is the legal representative that always comes in and discusses any new legal issues that are going on. Now, we’ve added on competitive bidding, and there are various workshops on competitive bidding. With retail being so important, we’ve had people come in and discuss the best ways to start up retailing. It’s a great time.

They’re usually at least two-day seminars — three days if you go to any of the special sessions. It gives you a good chance to network with other people and see how they’re doing things. Because I’ve been around so long, a lot of people are interested in what we’re doing that’s different, the latest and greatest. I always try to help. There’s enough business out there for all of us, the ones that are doing things correctly, at least. I feel that the least we can do is help one another.

Why is it important that providers join state/regional associations?
For the educational benefits. They can stay ahead. Medicare comes in and discusses all of the latest changes. Sometimes that’s scary, but they go over all of the changes. We have state Medicaid groups come in and discuss where they’re making changes. It always keeps you abreast of what is happening currently.

I think everyone needs to belong to a state organization no matter what state they’re in. And if they don’t have one, they need to see if they can snuggle up with an adjoining state. I just think it’s critical.

As a Houston provider, you’re slated to be in the next 70 MSAs for competitive bidding. How is your company preparing?
Actually, I’m not. I have in the past done a lot of bids because of our affiliation with the VA. I’m not concerned about that. We are JCHAO accredited already and have been for years. We have our corporate compliance up and running, and I guess there’s not a whole lot that I feel we have to do.

If you stay on top of it — and again, this is probably one of the things that MESA has done for me, has kept us on top of what’s going on, what’s coming down the road — if you act rather than having to react, then it’s not a crazy mess when the time comes because you’re really all set for it.

What do you think is the biggest challenge facing respiratory HME today?
This 36-month cap on oxygen. It’s not our problem nearly as much as it is the beneficiaries’ problem because they’re going to get stuck. They’re going to have equipment that’s not working. There’s no one checking it. It just worries me to death when I turn over ownership of one of those pieces of equipment to a beneficiary that doesn’t have the foggiest idea what they’re doing.

This article originally appeared in the Respiratory Management April 2008 issue of HME Business.

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