Policy Corner: September 16, 2022
Categories: Policy Corner Archives
House Passes Bill to Improve Access to Care for Seniors
On Wednesday, the U.S. House of Representatives passed H.R. 3173, the “Improving Seniors Timely Access to Care Act,” to improve the prior authorization process for health and medically necessary care, including seniors who sustain life-threatening conditions, such as brain tumors, stroke, and other brain injury. Specifically, the legislation:
- Establishes an electronic prior authorization (ePA) program;
- Standardizes and streamlines the prior authorization process for routinely approved services, including establishing a list of services eligible for real-time prior authorization decisions;
- Ensures prior authorization requests are reviewed by qualified medical personnel; and
- Increases transparency around MA prior authorization requirements and their use.
H.R. 3173 was introduced by Rep. Suzan K. DelBene (D-Wash.) and supported by Mike Kelly (R-Pa.), Judy Chu (D-Calif.), Stephanie Murphy (R-Fla.), and Ami Bera (D-Calif.), along with over 300 other co-sponsors. The Brain Injury Association of America supports the legislation.
Lawmaker Introduces Resolution for National Brain Health Day
Reps. Earl Blumenauer (D-Ore.) and Morgan Griffith (R-Va.) introduced a House Resolution this week expressing support for the designation of September 15, 2022, as National Brain Health Day. The resolution encourages increased public awareness of brain health; and supports efforts to study and to develop better treatments to improve brain health.
The resolution states that 1 in 6 people is affected by brain disease, including stroke, Alzheimer’s disease, Parkinson’s disease, migraine, epilepsy, autism, multiple sclerosis, brain injury, cerebral palsy, neurogenetic diseases, and other diseases of the brain and central nervous system. Furthermore, as the cost of neurologic disease in the United States exceeds $600,000,000,000 a year, there is an urgent need to foster brain health awareness and to support research to find cures.
VA Announces It Will Extend Eligibility for Certain Veterans and Their Family Caregivers
Following Senator Maggie Hassan’s (D-N.H.) push for the Department of Veterans Affairs (VA) to address concerns with the Program of Comprehensive Assistance for Family Caregivers, the U.S. Department of Veterans Affairs announced this week it will extend eligibility for certain veterans and their family caregivers through September 30, 2025. The VA Caregiver Program supports family members caring for veterans severely injured in the line of duty. The previous Administration narrowed the program’s eligibility, which the Senate Veterans’ Affairs Committee found that VA denied 88 percent of applications to the program between October 2020 and August 2021.
BIAA Supports CMS’ Proposed Rule on Dental Surgical Services Provided in Hospital Settings
The Brain Injury Association of America (BIAA) signed on to the Consortium for Constituents with Disabilities (CCD) Health Task Force letter this week to Chiquita Brooks-LaSure, Administrator for the Centers for Medicare and Medicaid Services (CMS), regarding the Prospective Payment System and Ambulatory Surgical Center Proposed Rule for calendar year (CY) 2023. The proposed rule addresses dental surgical services provided in hospital settings. BIAA and CCD support CMS’ proposal to make adjustments to the classification of the code used by hospitals to report outpatient dental procedures to ensure that the dental surgical services provided in hospitals are aligned with the most clinically appropriate code classification. And, the letter indicates support for CMS’ proposal in the 2023 Physician Fee Schedule (PFS) rule to cover medically necessary dental procedures.
Often, a hospital or another surgical setting, such as an ambulatory surgical center (ASC), is the optimal care setting to address the oral health care needs for certain children and adults with disabilities due to the time involved for extensive restorative dental surgical procedures which may involve complex equipment, general anesthesia, and other challenges. However, there has been an alarming decrease in operating room access for dental procedures over the last decade, particularly in rural areas.