steven p, rosenberg, m.d., p.a.
                   elaine zoberman-saltiel, m.d,
                   DIPLOMATES OF THE AMERICAN BOARD OF DERMATOLOGY
                   FELLOWS OF THE AMERICAN ACADEMY OF DERMATOLOGY


August 9, 1993


E.P. Clay Shaw, Jr.
1512 East Broward Blvd.
Suite 101
Fort Lauderdale, FL 33301

Attention:  Pamela


Dear Pamela:

I am enclosing a copy of the letter that I had previously sent to you, that
has been forwarded to Congressman Lewis.  As I indicated to you, I do live in 
Representative Shaw's district and, therefore, contacted your office. I tried 
to follow through with your recommendation, but unfortunately, did receive 
somewhat of a run around as the numbers provided for the Equal Opportunity
Department and from what I could ultimately determine, the responsibility for
interpreting the ADA falls with the Justice Department I would, therefore, 
respectfully request that you pursue the three item of concern. I was also
informed by a representative in the Justice Department that they would not be
capable of answering the question in reference to reimbursement by Medicare or
Medicaid for charges associated with hiring an interpreter. I had spoken
briefly with an attorney at the Department of Justice (Bee Bee Ellen Novich)
who informed me that the intent of the law was that these costs be passed on
to other clients or patients.  Ms. Novich seemed somewhat surprised that we
could not pass these costs on to Medicare beneficiaries or individuals insured
by HMO's or PPO's where these reimbursements had previously been fixed.
Certainly if that was the intent of the law then it seems reasonable that
Medicare should either pay, for these services or increase their
reimbursements to physicians if these costs were to be absorbed by a larger
group than the physicians themselves.

Thank you again your prompt reply of August 4, 1993, and I look forward to 
hearing from you promptly.

Sincerely,

Steve P. Rosenberg, M.D.

SPR/jd

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