In Indianapolis, there is recognition that reimbursement levels have influenced hospitals' behavior.

"With the power this gives us, we will work to increase staffing ratios and reimbursement levels for New York's nursing homes."

Private insurers are slowly reducing their reimbursement levels as well, though for most cancer patients they are still paying more than Medicare does.

Beverly's stock, which topped $12 a year ago before a fresh wave of concerns over reimbursement levels, is now trading at $7.30.

The increases were especially large here and in many other parts of the country where reimbursement levels were deemed inadequate to keep up with rising costs.

"We just can't sustain the level of service at those reimbursement levels," Ms. Reilly said.

Medicaid then pays the remainder of the cost, up to the reimbursement level set by the state.

Medicaid is financed jointly by the Federal Government and the states, and states set reimbursement levels.

Many law schools have recently raised reimbursement levels and salary caps - the top incomes that graduates may earn and still qualify for the program.

The insurance companies are squeezing the drug retailers on reimbursement levels.