Policy Corner: April 27, 2018

The Brain Injury Association of America (BIAA) submitted testimony to the House Appropriations Subcommittee on Labor, Health and Human Services (HHS), Education and Related Agencies this week calling for increased fiscal year 2019 funding for Traumatic Brain Injury (TBI) Act-related programs and the TBI Model Systems funded by the National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR). Specifically, BIAA requested $11 million total for HHS’ Administration for Community Living’s (ACL) TBI State Implementation Grant program; $6 million total for ACL’s Protection and Advocacy Grant Program; and $5 million additional fundingfor the Centers for Disease Control and Prevention’s (CDC) Injury Center to establish and oversee a national concussion surveillance system. BIAA also recommended $15 million for the NIDILRR TBI Model Systems, administered by ACL, to expand the number of centers and research projects and requested that appropriators oppose the President’s recommendation to move the program to the National Institutes of Health (NIH).

House Subcommittee Advances Bills to Combat the Opioid Crisis

This week, the House Committee on Energy and Commerce’s Subcommittee on Health advanced 57 bills to the full Energy Commerce Committee, of which 56 were focused on ways to help combat the opioid crisis. The Health Subcommittee, chaired by Rep. Michael C. Burgess, M.D. (R-Tex.), reported that the subcommittee worked in a bipartisan effort to improve access to care for individuals suffering from substance use disorder; to provide the nation’s health care system with tools and resources it needs to care for patients; and to help prevent future misuse of opioids. Among bills considered that is still in draft form is one designed to spur innovation in the development of nonaddictive treatments for pain and addiction by clarifying how such products can qualify for FDA pathways like breakthrough therapy designation and the accelerated approval program.

Senators Request Data from DOL on Subminimum Wages for Workers with Disabilities

Senator Elizabeth Warren (D-Mass.) and six Senators sent a letter Monday to U.S. Department of Labor (DOL) Secretary Alexander Acosta regarding employers that use 14(c) waivers to hire workers with disabilities and pay them less than the federal minimum wage. According to public DOL data, employers held more than 1,700 14(c) certificates covering more than 150,000 workers eligible to receive a subminimum wage as of January 2018. The Senators requested that DOL publicly report the pay rates of individuals with disabilities paid by employers using 14(c) certificates at the national and state level. In addition, the senators requested a variety of data on the Department’s evaluation of certificate applications, violations of the Fair Labor Standards Act among certificate holders, and the Department’s revocation of certificates, among other information. The Senators also expressed support for phasing out the discriminatory waivers in a responsible way. Co-signing the letter were Sens. Bob Casey (D-Pa.), Patty Murray (D-Wash.), Chris Van Hollen (D-Md.), Maggie Hassan (D-N.H.), Tammy Duckworth (D-Ill.), and Bernie Sanders (I-Vt.).

BIAA Signs on to Letter to CMS Regarding Bundled Payment

As a member of the Coalition to Preserve Rehabilitation (CPR), the Consortium for Citizens with Disabilities (CCD) Health Task Force, and the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, BIAA signed on to a letter to HHS Secretary Alex Azar, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, and Director of the Center for Medicare and Medicaid Innovation Adam Boehler, commenting on the new voluntary bundled payment model, Bundled Payments for Care Improvement – Advanced (BPCI-Advanced) initiative. The organizations expressed concern that bundled payment systems, among other things, compromise beneficiary choice of provider in an attempt to reduce expenditures and improve quality of care for Medicare beneficiaries in the fee-for-service program. The members of the undersigned coalitions and related supporting organizations oppose bundling of any kind because these payment mechanisms, without functional measures to prevent stinting on patient care, amount to little more than financial incentives to deny appropriate and medically necessary rehabilitation services and devices.

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action.