Policy Corner: February 17, 2023
Categories: Policy Corner Archives
Senate Committee Holds Hearing on Bills to Improve Services for Veterans with Disabilities
On Thursday, February 16, 2023, the Senate Veterans’ Affairs Committee, chaired by Senator Jon Tester (D-Mt.), held a hearing to consider several bills to improve home and community-based services and supports administered by the Department of Veterans Affairs (VA). Bills discussed included:
- S.132, the Daniel J. Harvey Jr. and Adam Lambert Improving Servicemember Transition to Reduce Veteran Suicide Act, sponsored by Senators Sherrod Brown (D-Ohio) and Sheldon Whitehouse (D-R.I.), which establishes a pilot program on activities under the pre-separation transition process of members of the Armed Forces for a reduction in suicide among veterans. The pilot program would educate cohorts on resources and systems of suicide risk and physical, psychological, or neurological issues, such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), chronic pain, sleep disorders, and substance use disorders. The program would provide information on resources and treatment options available through VA, the Department of Defense, and non-profit organizations.
- S.141, the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2023 or the Elizabeth Dole Home Care Act, sponsored by Senator Jerry Moran (R-Kans.), to improve and expand home and community-based services for older veterans and veterans with disabilities to ensure they are able to remain in their homes and receive the care they need. The bill establishes the “Veteran Directed Care program” for veterans who need assistance with activities of daily living. The program is to be carried out by an Aging and Disability Resources Center, an area agency on aging, or a state agency; and/or a center for independent living. VA is to provide not fewer than 30 days of covered respite care each year to any resident caregiver who provides services funded under the Veteran Directed Care program. The legislation also increases the expenditure cap for non-institutional care alternative programs; creates a pilot program to provide home health aide services veterans that reside in communities with a shortage of home health aide; and requires the creation of a centralized website to disseminate information and resources related to home and community-based programs. In addition to Senator Moran, Senators Tester and Maggie Hassan (D-N.H.) also support the legislation.
- S.216, Reinforcing Enhanced Support through Promoting Equity for Caregivers Act of 2023 or the RESPECT Act of 2023, to modify VA’s family caregiver program to include services related to mental health and neurological disorders in order to improve the provision of mental health support to family caregivers of veterans participating in the family caregiver program.
BIAA Supports CMS Rule Regarding Medicare Advantage and Prior Authorization
The Brain Injury Association of America (BIAA), as a member of the Steering Committee of the Coalition to Preserve Rehabilitation (CPR), signed on to a letter to Chiquita Brooks-LaSure, Administrator of the Centers for Medicare & Medicaid Services (CMS), in support of the 2024 Medicare Advantage (MA) proposed rule that requires numerous beneficiary protection improvements to MA plans. BIAA has long expressed concerns about the overuse of utilization management, especially prior authorization, in the MA program, which may result in inappropriately delayed or denied rehabilitative care in post-acute care settings, particularly inpatient rehabilitation hospitals/facilities. CPR has advocated on behalf of all patients, especially those with serious and complex conditions such as brain injury, stroke, multiple sclerosis, spinal cord injury, amputation, and other significant disabilities and chronic conditions, are able to access the medically necessary care they need in the most appropriate setting in order to maintain and improve their health and function.
Therefore, CPR supports the proposed rule that states that MA organizations must comply with all coverage guidance in Medicare manuals, National Coverage Determinations, and Local Coverage Determinations; and may not limit coverage through the adoption of utilization management and prior authorization policies and procedures. In accordance with the rule, MA organizations would be prohibited from utilizing internal guidelines limiting or denying coverage when the item or service would be covered under Traditional Medicare, including care provided in Skilled Nursing Facilities (SNF), home health services, and inpatient rehabilitation hospital services. CPR also commends CMS for incorporating patient and provider feedback into the development of this rule.
Organizations are Gearing Up for Brain Injury Awareness Month
The Brain Injury Association of America is refining their plans for Brain Injury Awareness Day and will be announced soon. In the past, this day has been an opportunity for the brain injury community to learn about advocacy and communicate with legislators.
The National Association of Head Injury Administrators (NASHIA) is holding a SEED Summit on March 7-8, 2023, at the Residence Inn Arlington Capital View, Arlington Virginia. The SEED Summit is hosted by Pennsylvania and will provide participants an opportunity to discuss strategies for building state service and support systems. Space is limited. Individuals who are interested may register here. NASHIA’s 2023 SEED Summit This meeting provides an opportunity for participants to fly in to Washington, D.C. and visit with their Congressional delegation in coordination with other stakeholders.
As a reminder, the Administration for Community Living’s (ACL) virtual “Traumatic Brain Injury (TBI) Partners Day” is scheduled for February 28, 2023, 12:00 – 4:00 pm (ET) in observance of March Brain Injury Awareness Month. There is no cost to register for the event. You may register for the event here.