Policy Corner: July 17, 2020

House Appropriations Committee Marks Up Spending Bill

The House Appropriations Committee marked up the Labor, Health and Human Services, Education, and Related Agencies appropriations bill for Fiscal Year 2021 (FY 2021), which begins Oct. 1. The committee recommended level funding for the Administration for Community Living (ACL) Traumatic Brain Injury (TBI) program; National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR); and the Centers for Disease Control and Prevention (CDC) TBI program. The committee is recommending a $12.5 million increase each to the National Institutes for Health and CDC for firearm & mortality research. Last year, was the first time in 20 years that funding was directed toward firearm research.

The committee included language and direction to the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) to work with all relevant institutes and centers, including National Institute on Aging (NIA), to support a robust and coordinated portfolio of TBI research that explores all promising avenues to facilitate functional repair of damaged circuitry in TBI. The Committee directs NINDS to provide an update regarding these specific areas of TBI research in the Fiscal Year 2022 Congressional Justification. The House of Representatives is expected to vote on the appropriations bill within the next two weeks. The Senate has not indicated when it intends to consider FY2021 appropriations bills, and may end up passing a continuing resolution to fund FY 2021 beginning Oct. 1.

House Energy and Commerce Committee Advances Health-Related Bills

The House Energy and Commerce Committee, chaired by Rep. Frank Pallone, Jr. (D-N.J.), reported 17 bills to the House of Representatives pertaining to health care. Included are:

• The Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act of 2019, H.R. 2477, introduced by Reps. Raul Ruiz (D-Calif.), Jackie Walorski (R-Ind.), Brad Schneider (D-Ill.) and Gus Bilirakis (R-Fla.), to improve beneficiary outreach and education, reduce gaps in coverage, and simplify the Medicare Part B enrollment process.
• The Protecting Patients Transportation to Care Act, H.R. 3935, introduced by Reps. Buddy Carter (R-Ga.), Tony Cárdenas (D-Calf.), Tom Graves (R-Ga.) and Sanford Bishop of (D-GA), which would amend the Medicaid statute to include non-emergency medical transportation (NEMT) in the list of mandatory Medicaid benefits by codifying current Medicaid NEMT regulations. The bill would also require state Medicaid programs to have in place a utilization management process for the benefit.
• The Telemental Health Expansion Act of 2019, H.R. 5201, introduced by Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio), which would permanently include a patient’s home as an eligible originating site for mental health services delivered via telehealth and remove Medicare’s geographic restrictions for such services, enabling providers to be reimbursed by Medicare for mental health services delivered via telehealth in urban and rural areas and in the patient’s home.
• The Suicide Prevention Lifeline Improvement Act of 2019, H.R. 4564, introduced by Reps. John Katko (R-N.Y.), Don Beyer (D-Va.) and Grace Napolitano (D-Calif.), which would increase the authorized funding level of the National Suicide Prevention Lifeline program to $50 million each year, from FY 2020 – 2022. The bill also directs the U.S. Department of Health and Human Services to establish a plan for maintaining the program and includes a pilot program to research, analyze, and employ various innovative technologies and platforms for suicide prevention.

BIAA Supports the IMPACT Act Reset Effort

As a member of the Coalition to Preserve Rehabilitation (CPR), the Brain Injury Association of America (BIAA), signed on to a letter in support of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 legislative package. The IMPACT Act directed the Centers for Medicare and Medicaid Services (CMS) and the Medicare Payment Advisory Commission (MedPAC) to develop a unified payment model for all four post-acute care settings, including inpatient rehabilitation facilities, skilled nursing facilities, home health agencies, and long-term care hospitals. Both CMS and MedPAC have been developing proposed models under the requirements of the IMPACT Act, but the timeline for implementation has slipped in the years since the legislation was enacted. CPR has long expressed concerns with the unification of PAC payment and the potential impact on patient access to care, especially as CMS policy continues to attempt to blur the distinction between higher and lower acuity settings of post-acute care. As such, BIAA and the CPR support an IMPACT Act reset and have outlined concerns to lawmakers that unified PAC payment without evaluating the needs of the most complex patients could have severe negative impacts on access to care.

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