hospitals, which for old-age and survivors insurance beneficiaries are excluded from the program. In the case of individuals who may be entitled to monthly benefits under both programs the limitations on number of days, units of care and the deductible provisions would be applied as if the individuals were covered under a single program.

The administration of present law requires close coordination between the Railroad Retirement Board and the BOASI in recordkeeping and claims processes. There has been continuing and extensive experience between these agencies in the kinds of coordination that would be required under a health benefits program. Where individuals are entitled under both programs, agreement would be reached on which organization will issue the identification card. Railroad hospitals and Canadian hospitals would send their requests for verification of eligibility direct to the Railroad Retirement Board. Hospitals in

the United States, other than railroad hospitals which do not have an agreement with the Secretary, would accept either card and a common procedure would be established for requesting verification of eligibility. The Railroad Retirement Board could be linked with the BOASI wire communications system. Bills could be paid under uniform policies and procedures, and the trust funds of the two programs could be adjusted periodically through the financial interchange provisions of the Railroad Retirement Act.

89

APPENDIX

MEDICAL ASSISTANCE FOR THE AGED Selected Characteristics of State Plans

Plans in effect prior to July 1, 1961:

Kentucky
Maryland
Massachusetts

Michigan

New York

Oklahoma

Puerto Rico

Virgin Islands
Washington

West Virginia

Plans (for which information is available) as proposed to go into effect before end of 1961:

Arkansas

Idaho

North Dakota

Oregon

South Carolina

Tennessee

Utah