Clinton and Schumer Call on New York Health Commissioner to Ensure New Yorkers Maintain Health Coverage
Clinton and Schumer Call on New York Health Commissioner to Ensure New Yorkers Maintain Health Coverage
Implementation of New Medicare Prescription Drug Program Jeopardizes Coverage for Those Eligible for Medicare, Medicaid and Employer-Based Retiree Health Coverage
Senators Hillary Rodham Clinton and Charles Schumer today called on the Commissioner of Health for the State of New York to put safeguards in place to protect New Yorkers who are in jeopardy of losing eligibility for health coverage as the new Medicare prescription drug program is implemented. Without action, New Yorkers dually eligible for Medicaid and Medicare and who also have employer-based retiree health coverage face a conflicting scenario in which any choice will result in termination of one type of health coverage.
Below is the text of their letter.
Dear Dr. Novello:
We are writing to express concern about a specific aspect of the implementation of the new Medicare prescription drug program. We understand that this new federal law has created many challenges for your Department, but need your help to ensure the continuation of Medicaid coverage for New Yorkers eligible for Medicare, Medicaid, and employer-based retiree health coverage.
As you know, the Centers for Medicare and Medicaid Services (CMS) have automatically enrolled individuals eligible for both Medicare and Medicaid (dual-eligibles) in a Medicare Part D prescription drug plan. It has issued guidance to states allowing them to condition Medicaid eligibility on enrollment in the Part D program, and New York is one of six states that has chosen to amend its state plan accordingly. Dual-eligible New Yorkers who are not enrolled in Medicare Part D as of January 1, 2006, will no longer be eligible for Medicaid.
However, through their employer subsidy program, CMS has also incentivized employers to condition health coverage for their retirees on disenrollment in the Part D program. For individuals who are eligible for all three types of coverage, this provides a conflicting scenario in which any choice will result in the termination of one type of health coverage: Medicaid if the dual-eligible disenrolls from Part D, and retiree health care if the individual stays enrolled in Part D.
We have learned through discussions with your staff that the Department is aware of this contradiction and working to address it. It is our utmost concern that dual-eligibles who disenroll from the Part D program in order to retain their employer-based retiree coverage do not experience any disruption in their Medicaid coverage. In addition, while CMS has primary responsibility for working with employers throughout New York State to ensure that retirees do not inadvertently and irrevocably lose their retiree health coverage because they choose or are auto-enrolled in the Part D program, we strongly encourage the Department to take an active roll in assisting CMS in protecting these dual-eligible retirees.
We urge you to act quickly to put safeguards into place that will protect dual-eligible New Yorkers from these scenarios. Dual-eligible New Yorkers should:
$ be exempted from termination of Medicaid coverage if their enrollment in Part D would result in the loss of other creditable coverage; $ receive clear guidance explaining the steps they need to take to retain all of their coverage if they belong to employer-sponsored health plans;
$ be notified well in advance of any termination of their Medicaid coverage; and
$ be afforded with options to prove the existence of their creditable coverage other than coming to a Medicaid office in person, given the physical limitations that members of this population may be more likely to experience.
Thank you for your consideration, and we look forward to hearing from you.
Sincerely,
Charles Schumer
U.S. Senator
Hillary Rodham Clinton
U.S. Senator
http://clinton.senate.gov/news/statements/details.cfm?id=249993&&