Policy Corner: March 17, 2023
Categories: Policy Corner Archives
Senators Introduce Legislation to Expand Medicaid Dental, Vision, and Hearing Coverage
Yesterday, Senators Bob Casey, Jr. (D-Pa.) and Ben Cardin (D-Md.) announced they were introducing legislation, the Medicare and Medicaid Dental, Vision, and Hearing Benefit Act, to enable more Medicaid and Medicare beneficiaries to access comprehensive dental, vision, and hearing coverage. Medicare does not cover those services, leaving many beneficiaries with no other options but to buy stopgap, short-term plans or go without coverage, due to the out-of-pocket costs for basic care. Medicaid can provide optional dental, vision, and hearing services, but the extent of the coverage varies by state. The proposed legislation would allow Medicare to cover dental, vision, and hearing services and increase the federal investment in Medicaid, incentivizing more states to provide these comprehensive services by providing an increase in the federal match.
The Senators’ press release cited research that shows that untreated dental, vision, and hearing problems can have negative physical and mental health consequences. People with lower incomes are three times more likely to have four or more untreated cavities than adults with higher incomes or private insurance. Vision loss is associated with increased risks for falls and mobility limitations among older adults, while hearing loss is associated with an increased risk of social isolation and cognitive decline.
Senate and House Announce Hearing Dates to Review FY 2024 Federal Spending Requests
This week, Senators Patty Murray (D-Wash.) and Susan Collins (R-Maine), Chair and Vice Chair of the Senate Appropriations Committee respectively, released a tentative calendar laying out Appropriations subcommittee hearings in the months ahead. On Wednesday, March 22, the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will hear from key officials from the U.S. Department of Health and Human Services about the agency’s request for fiscal year 2024 funding. On May 4, the Subcommittee will hear from National Institutes of Health (NIH) and will hear from the Department of Education on May 11.
The Senate Committee on Appropriations will again accept requests from Senators on their funding priorities. The deadline is April 13. It is expected that as in the past, there will be a “Dear Colleague” sign on letter in support of additional funding for Traumatic Brain Injury (TBI) Act programs that authorize funding for the Administration for Community Living (ACL) state grant and protection and advocacy programs; and ACL’s National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) program that conducts research, including funding for the TBI Model Systems.
The House Appropriations Committee has set March 24 as the deadline for House members to submit FY 2024 requests for Labor, Health and Human Services, Education, and Related Agencies. Congressional Brain Injury Task Force (CBITF) co-chairs, Reps. Bill Pascrell, Jr. (D-N.J.) and Don Bacon (R-Nebr.) are circulating among members a “Dear Colleague” letter to enlist support for increased TBI funding. Should you contact your Representative to ask for his or her support, you may let him or her know to contact Nicole in Rep. Pascrell’s office should he or she wish to sign on to the letter. Her email is: Nicole.Howell@mail.house.gov.
Meanwhile, the House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) and Subcommittee on Health Chair Brett Guthrie (R-Ky.) announced this week that U.S. Department of Health and Human Services Secretary Xavier Becerra will testify at a hearing to discuss President Biden’s Fiscal Year 2024 Budget Request on March 29.
CMS and ACL Issue Joint Statement on Today’s Deadline for States to Meet HCBS Settings Rule
Today, the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) issued a joint statement on the implementation of the Medicaid Home and Community-Based Services (HCBS) Settings Regulation that was issued in 2014. The statement reaffirmed the federal agencies goal to ensure that every person receiving Medicaid-funded HCBS has full access to the benefits of community living and that individuals with disabilities, including brain injury, have autonomy to make choices and to control the decisions in their lives. Effective today, all states must be fully compliant with the regulation’s requirements and may, through time-limited corrective action plans, have additional time to fully comply with the remaining criteria impacted by the COVID-19 public health emergency.
While the COVID-19 pandemic delayed the deadline for implementation, states have continued to work with stakeholders to ensure providers meet the requirement. Stakeholders have provided input to Statewide Transition Plans that described how states would comply with the settings rule by March 17, 2023, waiver applications, and proposed regulations. The rule was issued to create a more outcome-oriented definition of home and community-based settings, rather than one based solely on a setting’s location, geography, or physical characteristics. To help achieve this goal, the rule requires a person-centered process for planning HCBS, which means that the individual receiving services direct the planning process and that the plan reflects his or her own preferences and goals set for themselves.
About half of the states administer brain injury HCBS Medicaid waiver programs, while other states may offer similar services for individuals with a brain injury through State Plan HCBS options; managed care waivers for long-term services and supports; or waiver programs that may include other disabilities, such as physical disabilities or developmental disabilities. All these options must meet the settings rule to ensure that people have integrated community services of choice.