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For more than 20 years, Medicare has helped provide accessible, affordable health care for people age 65 and older and certain disabled people. But that system has been undermined, as the elderly face unpredictable health care costs that threaten their financial security.

Medicare assignment rates are established by the federal government as "reasonable rates." Yet many doctors do not accept those rates, charging more for services than Medicare will cover. That leaves the elderly paying the difference.

Last year Medicare beneficiaries in New York state paid nearly $11 million in excess charges for medical care, according to the U.S. Department of Health and Human Services. The average excess charge per claim was $53.47 -- second-highest in the nation.

This practice of excess charges must be stopped. Physicians must be required to accept the Medicare assigned rate as payment in full.

We have that opportunity. Legislation before the State Legislature -- A. 3500 and S. 3818 -- would require that doctors who treat Medicare patients accept the Medicare rate with no excess charges. The legislation also establishes strong penalties if the law is broken.

The Civil Service Employees Association fully supports this legislation. Senior citizens are spending more for health care now than they did before Medicare existed.

That is unacceptable. Those of our society who live on fixed incomes, who have contributed to our communities, who are members of our families deserve protection against skyrocketing health-care costs -- especially when they need health care the most.

Finally, the voluntary Medicare assignment program, which allows doctors to choose whether to accept Medicare rates, lacks the force of law, enforcement and commitment. For example, only 28.4 percent of New York state physicians were participating Medicare providers last year, ranking New York behind 39 other states.

We in CSEA believe mandatory Medicare assignment offers our senior citizens a measure of financial security at a time when such security is tenuous at best.

CSEA President

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