Wednesday, January 22nd 2003

Dear Senator:

The undersigned hospital organizations are writing to express our strong, unified support for the Graham (FL)-Kennedy amendment to the continuing appropriations bill that prevents the implementation of limits on coverage of emergency services for Medicaid managed care enrollees.

The policy changes were issued by the Centers for Medicare and Medicaid Services via a letter to State Medicaid Directors on December 20, 2002.  Pursuant to this letter, state Medicaid program limitations would apply to Medicaid managed care enrollees when they seek emergency services at hospital emergency departments.  Previously, state Medicaid programs were not permitted to place any limitations on coverage of emergency services provided to Medicaid managed care enrollees.

These policy changes threaten to severely harm access to emergency services for our most vulnerable people – the poor, disabled and elderly.  And, for the many hospitals that serve this population, such coverage limits could place an even greater burden on an already fragile financial foundation.

The policy changes were issued with little rationale provided and with no prior consultation with the public – enrollees, their advocates or their caregivers.  We appreciate your support in seeking to reverse these unwarranted changes.


American Hospital Association
Association of American Medical Colleges
Catholic Health Association of the United States
Federation of American Hospitals
National Association of Children’s Hospitals
National Association of Psychiatric Health Systems
National Association of Public Hospitals and Health Systems
National Association of Urban Hospitals
Premier, Inc.
VHA Inc.


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