Policy Corner: January 10, 2020

President Signs Appropriations Package and Extends PCORI for 10 Years

President Trump signed the Fiscal Year 2020 appropriations package to fund government through Sept. 30, 2020. The funding measure also reauthorized the Patient-Centered Outcomes Research Institute (PCORI) through Sept. 30, 2029. PCORI is an independent organization authorized by the “Patient Protection and Affordable Care Act of 2010” to study how different medications and treatments compare, so patients and their caregivers have the information they need to choose the health care and treatment options that are best for them. PCORI is the only research funder guided by input from patients. It is supported by the PCORI Trust Fund, which receives income each year from three funding streams: appropriations from the general fund of the Treasury, transfers from the Centers for Medicare and Medicaid trust funds, and a fee assessed on private insurance and self-insured health plans.

House Committee Considers Healthcare Coverage

The Subcommittee on Health of the Committee on Energy and Commerce held a legislative hearing entitled, “Legislation to Improve Americans’ Health Care Coverage and Outcomes.” During the hearing, Medicare Rights Center President, Fred Riccardi, urged Congress to pass the bipartisan Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, H.R. 2477. The purpose of the BENES Act is to modernize and simplify the Medicare Part B enrollment process.

Lawmakers Introduce Bill for Medicaid HCBS while Person is in the Hospital

The Brain Injury Association of America (BIAA) signed a letter sent by the Consortium for Citizens with Disabilities in support of the Isaiah Baker and Margie Harris-Austin Act, H.R. 5443. The bill, sponsored by Reps. Mary Kay Scanlon (D-Pa.) and Tom Emmer (R-Minn.), allows reimbursement of Direct Support Professionals (DSPs) services while a person receiving Home and Community-Based Services (HCBS) is in the hospital. The bill addresses a longstanding challenge in the 1915(c) HCBS waiver program that prevents individuals with disabilities and seniors who go to the hospital from bringing their DSP with them to help communicate with the hospital and other assistance they may need. The legislation brings 1915(c) HCBS waivers in line with other HCBS authorities which do allow payment for DSPs to provide personal assistance and other services when the individual they support has a short-term stay in an acute care hospital.

House Holds Hearing on NEMT

The House Committee on Energy & Commerce’s Health Subcommittee held a hearing on the Protecting Patients Transportation to Care Act, H.R. 3935, to codify Non-Emergency Medical Transportation (NEMT) into the Title XIX of the Social Security Act (Medicaid) and to ensure that NEMT is a mandatory benefit for every state Medicaid program. The bill is sponsored by Rep. Earl L. “Buddy” Carter (R-Ga.). Although NEMT is a mandatory Medicaid benefit, each state Medicaid program has discretion in how the benefit is offered. The Centers for Medicare and Medicaid Services has pushed to make NEMT an optional benefit, giving states even more discretion as to the extent the benefit is provided. This benefit offers non-emergency transportation to Medicaid beneficiaries for them to access health care appointments and services, such as adult day services, rehabilitation, and behavioral health.