As reported in the last issue of Skyline News (August 7, 2000), the U.S. Health Care Financing Administration (HCFA) is considering a regulatory change to the Federal Medicaid program that could cost New York State hundreds of millions of dollars in Federal Medicaid funding. The proposed changes would affect the way HCFA computes the so-called Medicaid upper payment limit, which determines what the Medicare program would have paid for similar services that are being reimbursed by the Medicaid program. Generally, Federal law does not allow a state to set reimbursement rates or engage in other Medicaid spending policies that would be more generous than those set by the Federal Medicare program. While HCFA is considering the regulations because of perceived abuses by states other than New York, Governor George Pataki, health care providers, and health care advocates have been concerned that the new rules would greatly reduce Federal spending on important health care programs for the poor in New York State. In the last few weeks, several members of the New York Congressional Delegation have sprung to action. Senator Charles E. Schumer and Congressman Charles Rangel have had a number of conversations with top Clinton Administration officials in an effort to ensure that New York is not hurt by any new policies. Senator Schumer and Congressman Rangel have been assured that Federal officials are looking for ways to end existing abuses without hurting states like New York, where Federal Medicaid funds are being spent legitimately. In addition, Congressman Eliot Engel last week began to circulate a letter among his colleagues in the House of Representatives that would be sent to key Clinton Administration officials asking them to reject any new policies that would harm important health care programs for low-income families. Several months ago, the New York Congressional Delegation, led by Congressman Rick Lazio and Congressman Rangel, sent a similar letter to Health and Human Services Secretary Donna Shalala. GNYHA is grateful to all members of the Congressional Delegation who have been working on this issue.