Key Policy Issues for the ‘2013 Roll on Capitol Hill’

roch-logoAs we gear up for the 2013 Roll on Capitol Hill June 16-19, we wanted to provide a snapshot of where some of the key policy issues affecting the SCI community stand, and what United Spinal may be advocating for at the Roll.

Complex Rehab Technology
Last year, 38 representatives cosponsored a bill, introduced by Rep. Joe Crowley (D-NY) that would have established a separate benefit category for CRT. The bill never made it to the floor before the end of the session, but we are building on the momentum that legislation gained. This March, Rep. Crowley and Rep. Jim Sensenbrenner (R-WI) jointly sponsored HR 942, Ensuring Access To Quality Complex Rehabilitation Technology Act of 2013. Like last session’s bill, HR 942 creates a separate benefit under Medicare for customized wheelchairs that will ensure people with spinal cord injuries and disorders living with significant disabilities such as multiple sclerosis, spina bifida or amyotrophic lateral sclerosis can obtain the medical equipment they need to live independent, fully-functioning lives.

Medicare currently does not have unique coverage for the more complex needs of individuals with disabilities and chronic medical conditions that require customized products and services that are medically necessary. We believe the creation of a separate benefit will actually result in decreased Medicare expenditures by averting hospitalizations due to such conditions as severe pressure sores and blood clots. In the interest of quality healthcare and optimal functionality for individuals with disabilities, a separate Medicare benefit category is warranted. For more on why CRT is unique and different from durable medical equipment, check out www.unitedspinal.org/positions/crt.pdf.

Convention on the Rights of Persons with Disabilities
The Convention on the Rights of Persons with Disabilities is a UN human rights treaty that promotes the ideals of the Americans with Disabilities Act around the world. The treaty sets out the obligations of countries that ratify it to promote, protect, fulfill, and ensure the rights of people with disabilities. As of February 2013, 156 nations have signed the treaty, including the United States, and 128 nations have ratified it.

Signing the CRPD signaled a preliminary endorsement of the CRPD. In order to have the effect of law, however, a treaty must be ratified. Ratification shows a country’s clear commitment to a treaty’s purpose. We believe that U.S. ratification of the CRPD is critical to maintaining our nation’s leadership on the development of disability rights throughout the world.

On December 4, 2012, the treaty was brought to the floor of the U.S. Senate for consideration. Unfortunately, the Senate failed to give its consent for ratification by a final vote of 61 to 38.
The CRPD is currently pending before the Senate Foreign Relations Committee. The next step is for the committee to hold hearings regarding the treaty.

Medicaid
Medicaid provides health coverage to over eight million non-elderly individuals with disabilities and nearly four million low-income Medicare beneficiaries with disabilities. Most long-term services and supports, including home and community based services such as personal attendants, are paid for with Medicaid funds. Medicaid can also help pay for durable medical equipment like wheelchairs or prosthetic devices, as well as assistive technology.

At the federal level, United Spinal Association is working from a number of angles to fight back against restrictions on Medicaid. Among our priorities are: 1) ensuring adequate funding for all Medicaid services, including waiver programs; 2) opposing restructuring of Medicaid funding to block grants or “per capita caps” that would shift costs to states and create pressure to cut funding for people with disabilities; 3) supporting programs that increase funding for home and community based services and create person-centered care; 4) advocating for integrated care for the consumer population on both Medicare and Medicaid; and 5) supporting funding for quality measures (i.e data collection) that track how well Medicaid programs allow for person-centered services, timely access to care, access to community services, housing and consumer satisfaction.

Medicare
Medicare services are a critical part of everyday life for many people living with spinal cord injuries and disorders, yet these services are continually in jeopardy. United Spinal is committed to fighting for the services the SCI/D community depends on, including access to rehab, the right equipment and affordable prescription drugs that meet their needs.

HR 713 and S 367, the Medicare Access to Rehabilitation Services Act of 2013, would ensure individuals can get the therapy they need by allowing them to obtain an exception to a cap or limit on their services that would allow Medicare to exceed the $1,900 limit for occupational therapy, physical therapy and/or speech-language pathology services.

We are working to reintroduce a bill to reform Medicare’s bidding program for durable medical equipment. The current program restricts choice and access to needed medical equipment such as wheelchairs and other supplies and results in consumers often being denied the equipment they need.

We are also working closely with other consumer stakeholders on introducing legislation to strengthen the design of the prescription drug benefit under Medicare Part D.