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Assembly trying to cut costs while fighting fraud

The Sept. 14 News editorial, "Wow, Assembly action on Medicaid?" completely dismisses the Assembly's efforts to ease the Medicaid burden on localities. First, the editorial hails as "welcome news" our announcement of public hearings to examine how the state can improve its efforts to fight Medicaid fraud. Surprisingly, it then disparages these same forums, which have been embraced by reformers for the public dialogue and input they provide into the formation of public policies.

The Assembly's investigation into Medicaid fraud and abuse raises critical questions about the Department of Health's oversight and involvement in the process. The Assembly already held one hearing on this topic, and others are being scheduled. The next will build on what was learned at our initial forum, as well as on additional research.

Medicaid exists to help vulnerable communities receive medical care, and that is why the Assembly majority is intent on ensuring that Medicaid dollars are being spent wisely and administered carefully. We want to know what experts, the medical community and the public think needs to be done.

Additionally, the issues surrounding Medicaid go beyond fraud. The Assembly has long advocated for effective solutions to lift the high cost of Medicaid from the shoulders of county taxpayers without compromising quality health care.

In 1994, the Legislature enacted a law requiring New York State to pick up a greater share of Medicaid long-term care and managed-care costs from local governments. Had Gov. George E. Pataki adhered to that law instead of succeeding in repealing it, localities would now have saved more than $700 million.

In 1999, the Assembly proposed implementing the Family Health Plus program without a local share. If Pataki had accepted our proposal, local governments could have saved $850 million to date.

This year, the Assembly fought for a "hard cap" that would have permanently kept the local share of Medicaid spending at the 2005 level. It would have saved county governments an estimated $466 million in 2006 over the governor's proposal, which was enacted.

Furthermore, the Assembly has repeatedly called for New York to receive its fair share of Medicaid dollars from the federal government. Currently, we receive only 50 percent federal reimbursement, while some states receive 75 percent. If we picked up 5 percent more, New York would receive nearly $3 billion in additional federal reimbursement.

The Assembly majority has always worked cooperatively with the governor and the Senate on Medicaid relief. Where we differ with the Senate and governor is that we steadfastly refuse to redefine Medicaid "relief" as cuts in the health services that women, the disabled, children, seniors and working families need.

An efficient and effective system must be in place to combat Medicaid fraud. Public hearings allow legislators to review critical issues and act with the benefit of real-world experience provided through informed, constructive discussions.

Democrat Sheldon Silver is speaker of the New York State Assembly.

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