Memorandum in Support: A.4911 Cahill
Restoration of the Medicaid-Medicare "Crossover" Cut

The New York Chapter of the American College of Emergency Physicians (New York ACEP) would like to thank the New York State Legislature for restoring 20% of a cut proposed in the Executive's 2003 budget relating to Medicaid reimbursement for Medicare co-insurance amounts for certain health care services and supplies for individuals who are eligible for both Medicaid and Medicare. However, a full restoration of this cut is necessary to preserve access to services and supplies for the State's most vulnerable populations- the poor, elderly, physically disabled, mentally ill, developmentally disabled and other persons with disabilities.

Currently, Medicare pays only 50% of the cost of psychiatry services and 80% of the cost of other services, including durable medical equipment, physician care, psychiatry care, emergency services provided pursuant to a contract with a hospital, podiatric care and pharmaceutical products. Prior to the enactment of the 2003 budget, the Medicaid program provided full reimbursement for the remaining 50% and 20% respectively.

Many individuals who are dually eligible rely heavily on medical equipment and services for daily living, including wheelchairs, augmentative communication devices ("touch talkers"), oxygen, feeding equipment, and insulin pumps. The remaining cut may lead to a lack of access to such services and equipment by the elderly and disabled which will result in a loss of independence to these individuals.

In addition, physician services will be adversely affected as providers who are already under-reimbursed by the Medicaid program struggle to serve these individuals while suffering huge financial losses.

Full restoration of this Medicaid cut will protect low-income elderly individuals and people with disabilities. It will cost the State less money over the long term by preserving the independence and productivity of these individuals in the community.

The New York Chapter of the American College of Emergency Physicians
represents over 1,500 physicians statewide who are one of the largest indigent care
providers in the state, serving as the entry of last resort to all patients 24 hours a
day, 365 days a year. We respectfully request your support for the full restoration of
the Medicaid-Medicare "Crossover" cut, as provided by A.4911.