N.Y. providers fight cut

Saturday, January 31, 2004

ALBANY, N.Y. - A coalition of healthcare providers fighting a 16% “crossover” cut to the dually eligible co-pay won a recent victory when a state assemblyman introduced a legislative repeal of the cut in January.

The New York Medical Equipment Providers Association has been working with physicians, pharmacists and other medical associations to repeal the law, which was implemented July 1, 2003.

“The full coalition is asking for a repeal because providers can not sustain additional cuts, and more importantly we want to assure there is access to HME for the disabled and elderly population,” said Jackie Negri, executive director of NYMEP.

Assemblyman Kevin Cahill introduced the repeal bill last month after working with members of the coalition. Negri said the future of this repeal will depend significantly on the governor’s forthcoming budget plan.

The cut, when first proposed last year, called for a total elimination of Medicaid reimbursement to those DME providers who serve people who are dually eligible for Medicaid and Medicare. The final version of the law, however, provided a 20% restoration of the reimbursement in circumstances where the Medicare payment exceeds the entire Medicaid rate, according to a document created by NYMEP.

“On top of everything that is happening at the federal level my question is how much can providers sustain?” asked Negri. “It’s unjust. Is anyone thinking of the client?”

The coalition met with the state’s Department of Health in January to discuss its concerns, and Negri said it was a productive discussion.

“The department is willing to work with the provider community,” she said. “No doors were shut.”