Policy Corner: August 17, 2018

Senate Returns to the Capitol to Tackle Appropriations

The Senate returned to the Capitol this week, after a short August recess, to consider presidential appointments and the fiscal year 2019 spending bills. Prior to the July 4 recess, the Senate Appropriations Committee had approved all twelve appropriations bills that would fund federal government beginning Oct. 1. The Senate debated yesterday and agreed to combine the Pentagon spending bill and the Labor, Health and Human Services (HHS), Education, and Related Agencies bill together in a “minibus” appropriations bill and take the bill up next week. The president has indicated that he does not support this approach due to the spending recommendations for domestic programs. Several disability and health care programs are recommended for level funding, including funding for the federal Administration for Community Living’s TBI Program, which is $2 million more than the previous year. The administration has proposed cuts to many of the domestic programs. The House of Representatives is scheduled to return Sept. 4, after Labor Day.

Lawmaker Introduces Violence Against Women Reauthorization Act

Rep. Sheila Jackson (D-Tex.) introduced H.R.6545, the Violence Against Women Reauthorization Act of 2018, which was first passed in 1994 to address needs of survivors of domestic violence, dating violence, sexual assault, and stalking. There are 124 co-sponsors. The Violence Against Women Act (VAWA) provides a lifeline for survivors of domestic violence, dating violence, sexual assault, and stalking. VAWA expires this year and must be reauthorized to ensure a continued federal response to these crimes. VAWA programs may be targeted to address a particular service need, such as transitional housing or civil legal assistance, and some are designed to address the needs of particular populations. In a few states, training has taken place among domestic violence and healthcare providers with regard to identifying behavioral and cognitive issues relating to brain injury resulting from domestic violence.

BIAA Signs Letter Calling for House-Senate Conference Committee to Support SNAP

Now that both the House and Senate have passed “Farm Bill” legislation, the bill  goes to a House-Senate conference committee to settle the differences between the two versions that were passed. One of the differences relates to the Supplemental Nutrition Assistance Program (SNAP), often referred to as “food stamps.” The House included cuts to the program and proposed tougher work requirements for recipients. While adults receiving disability benefits would likely be automatically exempt from the expanded work requirements, many people with disabilities do not receive those benefits and would have to prove they qualify for an exemption. Other recipients may be caregivers for adult and child family members with health impairments and would not be able to work in order to provide for their family members. The Senate bill does not include the House bill’s proposed cuts.

The House and Senate conferees are now negotiating differences and hope to have a final Farm Bill ready for consideration before the current authorization expires Sept. 30. BIAA has signed a letter produced by the Consortium for Citizens with Disabilities (CCD) urging conferees to continue the longstanding bipartisan commitment to protect and strengthen SNAP and to reject any proposals to restrict eligibility, reduce benefits, cap or reduce funding, or make harmful structural changes.

CRT Stakeholders Continue to Work to Stop CMS’ DME Competitive Bid Program

Complex Rehab Technology (CRT) stakeholders continue to work with Congress to stop the Centers for Medicare and Medicaid Services’ (CMS) inappropriate use of durable medical equipment (DME) Competitive Bid Program information to cut Medicare payment rates for accessories (critical components) used with Complex Rehab Manual Wheelchairs. While CMS has changed the policy for Complex Rehab Power Wheelchairs, it has not made the needed change for accessories used with Complex Rehab Manual Wheelchairs.

To evaluate the impact these payment cuts are having on Medicare beneficiaries with significant disabilities’ access to this specialized technology, the National Coalition for Assistive and Rehab Technology (NCART) conducted a confidential survey of Medicare CRT suppliers in July. The survey results indicate a major drop in access; 65% of the companies indicated the cuts have “significantly reduced [their] ability to provide the right wheelchair accessories to Medicare beneficiaries who require Complex Rehab Manual Wheelchairs.” An additional 22% of the companies indicated that they have been holding off on reductions awaiting Congressional action but “if such relief does not come within the next 90 days [they] will be forced to reduce the related accessories and services [they] provide.”

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