bpclc letter re cms-9989

8/3/2019 Bpclc Letter Re Cms-9989

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BPCLC_Sign-On_CMS-9989-P Legislative Office Bldg, 617, Albany, NY 12247

October 24, 2011

The Honorable Kathleen Sebelius

Department of Health and Human Services

Commissioner Donald Berwick

Centers for Medicare & Medicaid Services

Attention: CMS – 9989 – PP.O. Box 8010

Baltimore, MD 21244 – 8010

Re: CMS – 9989-P; Proposed Rules for Establishment of Exchanges and Qualified

Health Plans Under the Patient Protection and Affordable Care Act

Dear Secretary Sebelius and Commissioner Berwick:

We are writing to strongly encourage you to implement the Affordable Care Act in a way

that meets the needs of the citizens of New York. Improving access to quality, affordablehealth care remains one of our top priorities for the members of the New York State

Bipartisan Pro-Choice Legislative Caucus. Specifically, a principal concern in New York

is ensuring that our residents have both the opportunity to purchase the health insurancecoverage they need, and access to available local health care providers.

In order for expansions in health insurance coverage to work, newly insured Americansmust have access to an available and local network of health care providers. This is

especially important for Americans who are low-income and live in medically

underserved communities. Recognizing this, Congress included Section 1311(c)(1)(C) in

the health care reform law. This provision requires health plans sold through state-based

health insurance Exchanges to include essential community providers in their networks.

Essential community providers are crucial to New York’s health care delivery system

because communities across the state rely on them for primary and preventive healthcare. In the economic downturn, more women and men are turning to these providers for

basic health care.

In implementing section 1311(c)(1)(C), it is vital that HHS place special emphasis on

addressing the unique health care access issues that women face. For example, while wait

New York State

[email protected]




times increased for many types of providers after Massachusetts enacted its health care

reform, it was most problematic for women’s health care providers. Wait times forOB/GYN services increased dramatically – to 70 days in the Boston area.

It is critical that HHS put protections in place to ensure women do not face similar access

problems around the country. To achieve true health care access for women’s primaryand preventive care, the final rule on state-based health insurance Exchanges must follow

Congress’ intent by requiring Exchange-participating health plans to contract with all

women’s health centers and family planning clinics in their region.

It is also important that health plans be required to contract with these providers for all of

the covered health services they provide. It is equally important that HHS establish asolid benchmark to ensure adequate reimbursement for essential community providers.

These protections are fundamental to creating a meaningful essential community provider

standard and would go a long way towards ensuring continuity and coordination of

care — top priorities for the state of New York.

On the separate issue of health insurance coverage, we also encourage the final rule to

include policies that ensure people can continue to purchase the comprehensive healthinsurance coverage they have today. As such, we urge HHS to implement Section 1303

of the Affordable Care Act in a way that is in line with insurance industry practices.

We look forward to working with you to make our nation’s health care system work better for Americans across the country.

Please feel free to follow up with the NYS Bipartisan Pro-Choice Caucus via the office of State Senator Liz Krueger at (212) 490-9535 or at the address listed below.

Thank you for your consideration.

Sincerely,

Senator Eric Adams Assemblymember Thomas J. Abinanti

Senator Tony Avella Assemblymember James F. Brennan

Senator Neil D. Breslin Assemblymember Harry B. Bronson




Assemblymember Kevin A. Cahill Senator David Carlucci

Senator Martin Malavé Dilan Assemblymember Jeffrey Dinowitz

Senator Thomas K. Duane Assemblymember Steve Englebright

Senator Adriano Espaillat Assemblymember Sandy Galef

Assemblymember Deborah J. Glick Assemblymember Richard N. Gottfried

Senator Ruth Hassell-Thompson Assemblymember Andrew Hevesi

Assemblywoman Rhoda S. Jacobs Assemblymember Ellen Jaffee

Assemblymember Brian Kavanagh Assemblymember Micah Kellner

Senator Jeffrey D. Klein Senator Liz Krueger

Assemblymember Rory I. Lancman Assemblymember George S. Latimer

Assemblymember Charles D. Lavine Assemblymember Barbara Lifton




Assemblymember Donna A. Lupardo Assemblymember Alan Maisel

Assemblymember Margaret M. Markey Assemblymember Joel M. Miller

Assemblymember Joan L. Millman Senator Velmanette Montgomery

Assemblymember Catherine Nolan Assemblymember Daniel J. O’Donnell

Senator Suzi Oppenheimer Senator Kevin S. Parker

Assemblymember Amy Paulin Assemblymember Crystal D. Peoples-Stokes

Senator Gustavo Rivera Assemblymember Linda B. Rosenthal

Assemblywoman Addie J. Russell Senator John L. Sampson

Senator Diane J. Savino Assemblymember Teresa R. Sayward

Assemblymember William Scarborough Assemblymember Michelle Schimel

Senator José M. Serrano Senator Daniel L. Squadron




Senator Toby Ann Stavisky Senator Andrea Stewart-Cousins

Assemblymember Fred W. Thiele, Jr. Senator David J. Valesky

bpclc letter re cms-9989

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