Choices for Increased Mobility Act of 2026

Issues related to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, trade and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005 - DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - Competitive Bidding Relief Act (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; Issues related to H.R. 2902/S. 1406 - SOAR Act of 2025; Issues related to S. 4037 - Diabetes Act.

Client expense: $390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

United Spinal continues to advocate for H.R. 4206, the CONNECT for Health Act. United Spinal continues to advocate about the concerns we have about proposals for major restructuring of the Department of Health and Human Services programs. We want to make sure that critical programs, services, and funding for the disability and aging communities, such as the Centers for Independent Living, Home and Community-Based Services and the National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR) are not negatively impacted. United Spinal continues to support timely wheelchair repairs legislation that is currently being drafted in the Senate. United Spinal continues to support S.247 and H.R.1703, Improving access to lightweight carbon fiber and titanium wheelchairs, which will allow individuals with mobility challenges to choose the wheelchair that is best suited for their medical, functional, and lifestyle needs and preferences, without increasing costs to the Medicare program. United Spinal participated in and invited members of Congress and their staffs to participate in the National Coalition for Assistive and Rehab Technology (NCART), the International Registry of Rehabilitation Technology Suppliers (iNRRTS), and U.S. Rehab sponsored Complex Rehab Technology (CRT) Product Expo in Washington, D.C. on May 13, 2026. This event was designed to educate Members of Congress about CRT equipment and the individuals who rely on it every day to live safely and independently. We advocated on three issues with members of Congress and their staff about Complex Rehab Technology equipment and services, specifically: 1.Opening the Power Standing Coverage Determination process with the Centers for Medicare and Medicaid Services. 2.Passage of H.R. 1703 / S. 247 - the Choices for Increased Mobility Act of 2005, 3.Passage H. R. 9364, eliminate Prior Authorization for Wheelchair Repairs for Medicare Advantage United Spinal, along with other members of the. Disability and Rehabilitation Research Coalition (DRRC) wrote to Health and Human Services Secretary Kennedy to express our serious concern regarding the significant delay in the release of the Notice of Funding Opportunity (NOFO) for the National Paralysis Resource Center, which is currently operated by the Christopher & Dana Reeve Foundation under a cooperative agreement with the Administration for Community Living (ACL). United Spinal submitted comments to the Access Boards development of standards for Universal Changing Stations, Docket Number: ATBCB-2026-0001, RIN Number: 3014-AA50. In our comments, we thanked Senator Maggie Hassan for her leadership in establishing the requirement for Universal Changing Stations in the bipartisan Federal Aviation Administration (FAA) Reauthorization Act of 2024. The comments included the following summary: The United Spinal Associations recommendation to use existing industry standards is consistent with the National Technology Transfer and Advancement Act of 1995 (NTTAA) which encourages Agencies to use and participate in the development voluntary consensus standards. The Board is a valued member of the ICC A117.1 Standards development team and has considerable influence over the process and the ultimate requirements. It would be unfortunate if the Board were not to exploit this work by using it to advance its own mission. Collaboration of this type maximizes the Boards resources and encourages better understanding of the needs of all parties. As follow-up to our Virtual Advocacy Day held in March, United Spinal continued to advocate with members of Congress and or their staff on the following issues: Insert language into the FY27 Labor-HHS-Education appropriations bills committee report providing $2.5 million to fund four additional SCI Model System Suggested programmatic language: The inclusion of ostomy, urological and tracheostomy supplies in the Medicare competitive bidding program may conflict with the Administrations goals to strengthen American manufacturing, secure our medical supply chains from foreign adversaries, and protect the health and well-being of our nations most vulnerable citizens. Competitive bidding threatens to transfer this market to foreign competitors who have no commitment to American workers, American communities or American patients. And or: Suggested appropriations report language: Competitive Bidding for Ostomy, Tracheostomy, and Urological Supplies - The Committee is concerned about the Centers for Medicare & Medicaid Services decision to include ostomy, tracheostomy, and urological prosthetic supplies in the Medicare Competitive Bidding Program (CBP). These prosthetic devices have never been included in the program. The Committee is concerned that subjecting these prosthetic devices to competitive bidding without sufficient analysis could disrupt patient access, compromise clinician decision-making, harm domestic manufacturing, and increase Medicare costs. Accordingly, the Committee directs CMS to delay the implementation of competitive bidding for ostomy, tracheostomy, and urological supplies until the Administrator submits a report to the Committees on Appropriations, providing: (1) an assessment of the prospective downstream costs to the Medicare Part A program for adverse health events due to patients seeing limited or no access to the supplies of their choice; and (2) an evaluation of the potential impact on the US domestic supply chain, including manufacturing and distribution capacity and service industries associated with patient management if no or a limited number of US businesses are selected for the CBP. The Committee directs CMS to collect citable data from patient, clinician and manufacturer stakeholders. The Committee directs CMS to maintain current payment methodologies for these prosthetic devices until the Committee is briefed by CMS on all findings. United Spinals annual advocacy event, Roll on Capitol Hill, was held on June 24th. Advocates met with members of Congress and of their staff seeking action on four issues: Support Rep. Ayanna Pressleys (D-MA) bill, H. R. 9364, the FAST Repairs for Wheelchairs Act, which would prohibit Medicare Advantage plans from requiring prior authorization for wheelchair repairs. Carbon fiber and titanium wheelchairs are lighter, stronger and more responsive than standard wheelchairs chairs. But because of a policy change, Medicare beneficiaries have to pay the full cost out of pocket. The Choices for Increased Mobility Act (H.R. 1703/S. 247) would explicitly require Medicare to create new codes to allow suppliers to bill consumers for just the cost of the upgrade to an ultralight manual wheelchair. This bill is sponsored in the House by Reps. John Joyce (R-PA), Vern Buchanan (R-FL), and Kim Schrier (D-WA), and in the Senate by Senators Marsha Blackburn (R-TN) and Tammy Duckworth (D-IL). Support forthcoming legislation that will exclude ostomy and urological supplies from Medicares durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program for a period of five years while requiring the Centers for Medicare and Medicaid Services (CMS) to undertake a more comprehensive and clinically informed review of the impact that competitive bidding policies could have on beneficiary access, product choice, and patient outcomes. And other related provisions. urging Members of Congress to protect and strengthen home and community based services (HCBS), which already operates within a fragile system challenged by workforce shortages, long waiting lists, and inadequate funding. Millions of older adults and people with disabilities rely on HCBS to live independently in their homes and communities, and demand for these services will continue to grow as the population ages. Further cuts or restrictions would worsen existing barriers, increase the risk of institutionalization, and leave many without the support they need. Investing in and preserving HCBS is essential to ensure current and future generations can access quality care at home. United Spinal supported, S. Res. 685, sponsored by Senator Edward J. Markey (D-Mass.), member of the Commerce, Science, and Transportation Committee, and Senator Kevin Cramer (R-N.D.) designating April 22, 2026, as National Assistive Technology Awareness Day.

Medicare NCD on access to power standing systems; Prior authorization reforms to speed access for people with serious disabilities; HR 5081, DMEPOS Relief Act of 2025; HR 1703/S247 Choices for Increased Mobility Act of 2025

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Healthcare supply chain and resiliency, issues related to federal Medicare/Medicaid reimbursement for medical products, DMEPOS Relief Act of 2025/Competitive Bidding Relief Act (H.R. 2005/S. 2951), Choices For Increased Mobility Act (H.R. 1703/S. 247), Supplemental Oxygen Access Reform Act of 2025 (H.R. 2902/S. 1406), Diabetes Interventions Addressing Barriers to Enrollment, Technology, and Education Services (DIABETES) Act (S. 4037), The Medicare Advantage Improvement Act of 2026 (S. 4384/H.R. 8375), The Improving Access to Medicare Coverage Act (S. 4641/H.R. 3954), The Ensuring Seniors Access to Quality Care Act (S.4467/H.R. 7096)

Client expense: $400,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Issues related to Medicare durable medical equipment competitive bidding. Issues related to competitive bidding, including S. 4037, the DIABETES Act. Issues related to competitive bidding and payment rates in non-competitive bidding areas, including H.R. 2005 / S. 2951, the Competitive Bidding Relief Act of 2025. Issues related to titanium/carbon wheelchair upgrades, including S. 247 / H.R. 1703, the Choices for Increased Mobility Act of 2025. Issues related to Medicare oxygen therapy services, including H.R. 2902 / S. 1406, the SOAR Act. Issues related to regulatory relief and program integrity.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; H.R.1703, Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, trade and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005 - DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - Competitive Bidding Relief Act (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; Issues related to H.R. 2902/S. 1406 - SOAR Act of 2025; Issues related to S. 4037 - Diabetes Act.

Client expense: $360,000 · Firm income: Not reported

Issues related to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, trade and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - Competitive Bidding Relief Act (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; Issues related to H.R. 2902/S. 1406 - SOAR Act of 2025; Issues related to S. 4037 - Diabetes Act.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Lobbied in favor of HR 2005 - Medicare reimbursement expansion Lobbied in favor of S 247 & HR 1703 - access to titanium and carbon fiber wheelchairs Lobbied in favor of S 4037 - the Diabetes Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

United Spinal continued to advocate for H.R. 4206, the CONNECT for Health Act. https://www.congress.gov/bill/119th-congress/house-bill/4206 United Spinal continues to advocate with members of Congress for increased federal funding for the Spinal Cord Injury Model Systems as well as the Burn Model Systems and the Traumatic Brain Injury Model Systems. Increased funding at all three Model Systems, including the Model Systems Knowledge Translation Center is needed to translate data, research, and clinical knowledge into resources to benefit the SCI, TBI and burn injury communities. United spinal continues to advocate about the concerns we have about proposals for major restructuring of the Department of Health and Human Services programs. We want to make sure that critical programs, services, and funding for the disability and aging communities, such as the Centers for Independent Living, Home and Community-Based Services and the National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR) are not negatively impacted. United Spinal continues to support timely wheelchair repairs legislation that is currently being drafted in the Senate. United Spinal continues to support S.247 and H.R.1703, Improving access to lightweight carbon fiber and titanium wheelchairs, which will allow individuals with mobility challenges to choose the wheelchair that is best suited for their medical, functional, and lifestyle needs and preferences, without increasing costs to the Medicare program. https://www.congress.gov/bill/119th-congress/house-bill/1703/all-info United Spinal continues advocating for restoring federal appropriations for the Department of Defenses Spinal Cord Injury Research Program (SCIRP). Advocated for Congress extending the current telehealth provisions before the last deadline and also support H.R. 1614 to make physical therapists and occupational therapists permanently authorized providers of telehealth under Medicare. H.R. 1614, the Expand Practitioners Eligible to Furnish Telehealth Services Under the Medicare Program Act, introduced by Representatives Mike Kelly (R-PA), Mike Thompson (D-CA), and Adrian Smith (R-NE) has bipartisan support to eliminate the need for continued extensions, instructing Centers for Medicare and Medicaid Services to permanently adopt the temporary waiver of restrictions on payment for telehealth services delivered by physical therapists, occupational therapists, and other qualified healthcare. United Spinal provided a letter of support for research proposal addressing chronic pain for submission to the Patient Centered Outcomes Research Institute (PCORI) PLACER mechanism. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, along with numerous other organizations, wrote to the bipartisan leadership of the House Energy and Commerce Committee to express strong support for H.R. 5343, the Ensuring Patient Access to Critical Breakthrough Products Act. This bipartisan legislation would ensure that Food and Drug Administration (FDA) designated breakthrough devices and technologies are covered under Medicare during a four-year transitional period, while also establishing a pathway to make a permanent coverage determination. The ITEM Coalition believes this bill would be a positive step in the right direction towards ensuring timely access to breakthrough devices and technologies for millions of Medicare beneficiaries. The letter urged the House Energy & Commerce Committee to hold a markup on H.R. 5343 as soon as possible in the second session of the 119th Congress. https://itemcoalition.org/wp-content/uploads/2026/03/item-letter-to-ec-re-h.r.5343-the-ensuring-patient-access-to-critical-breakthrough-products-act-final.pdf United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition steering committee, along with numerous other organizations, submitted comments of support in response to the U.S. Customs and Border Protections (CBP) proposal to revoke rulings that currently allow certain portable aluminum ramps from China to enter the United States duty-free under subheading 9817.00.96 of the Harmonized Tariff Schedule pursuant to the Nairobi Protocol. United Spinal, along with numerous other steering committee members of the Coalition to Preserve Rehabilitation (CPR), wrote to thank the bipartisan leadership of the House of Representatives and their appropriations colleagues for including critical funding for programs that are essential to individuals with disabilities, chronic conditions, and injuries in the Fiscal Year (FY) 2026 Labor, Health and Health and Human Services, Education, and Related Agencies (Labor-HHS-Education) appropriations conference report. The letter urged the House of Representatives to pass the important legislative package as expeditiously as possible to avoid another federal government shutdown on February 1, 2026. https://preserverehab.org/wp-content/uploads/2026/01/cpr-letter-to-house-leadership-re-fy-2026-labor-hhs-education-appropriations-package-final.pdf United Spinal and other members of the Coalition to Preserve Rehabilitation (CPR),wrote the sponsors of H.R. 5940/S. 3480, the Seniors Deserve Streamlined Medical Approvals for Timely, Efficient, Recovery (SMARTER) Care Act of 2025 to express strong support for this bipartisan legislation. The letter read in part, CPR believes this important legislation is urgently needed to protect Medicare beneficiaries from harmful disruptions in care by preventing the implementation of the Wasteful and Inappropriate Services Reduction (WISeR) model, scheduled to begin on January 1, 2026. https://preserverehab.org/wp-content/uploads/2026/01/cpr-letter-of-support-for-h.r.5940-the-seniors-deserve-smarter-care-act-final.pdf United Spinal staff attended Unite2Fights 20th Annual Science & Advocacy Symposium Congressional briefing to advocate for spinal cord injury research and related issues. United Spinal and other members of the Consortium for Constituents with Disabilities (CCD) Health Task Force, submitted comments in response to the Department of Educations Request for Information about Artificial Intelligence, HHS Health Sector AI RFI, RIN 0955-AA13. The comments read in part, People with disabilities and their caregivers have significant concerns about the adoption and use of AI in clinical care. These concerns include a lack of transparency that make it hard or impossible to understand the basis for treatment reductions or denials, or even whether technology is being used, inadequate testing and auditing of the data and algorithms that drive AI decisions, and the absence of meaningful federal regulation and oversight. We urge the Department to review and consider the growing body of research and lived experience which shows that AI poses serious risks of harm,especially to people with disabilities. HHS must prioritize protecting people by carefully collecting, analyzing, and publicly sharing disaggregated data from all developers and deployers and by evaluating long-term patient outcomes before rapidly deploying new technology. HHS should not sacrifice these essential safeguards for health and safety for the sake of administrative convenience and speed. https://c-c-d.org/fichiers/CCD-Health-HHS-RFI-on-AI-2.23.2026.pdf

Medicare NCD on access to power standing systems; Prior authorization reforms to speed access for people with serious disabilities; Service and repair reforms in health programs; HR 5081, DMEPOS Relief Act of 2025; HR 1703 Choices for Increased Mobility Act of 2025

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; H.R.1703, Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - Competitive Bidding Relief Act (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; Issues related to H.R. 2902/S. 1406 - SOAR Act of 2025; Issues related to S. 4037 - Diabetes Act.

Client expense: $480,000 · Firm income: Not reported

Issues related to Medicare durable medical equipment competitive bidding. Issues related to competitive bidding, including S. 4037, the DIABETES Act. Issues related to competitive bidding and payment rates in non-competitive bidding areas, including H.R. 2005 / S. 2951, the Competitive Bidding Relief Act of 2025. Issues related to titanium/carbon wheelchair upgrades, including S. 247 / H.R. 1703, the Choices for Increased Mobility Act of 2025. Issues related to Medicare oxygen therapy services, including H.R. 2902 / S. 1406, the SOAR Act. Issues related to regulatory relief and program integrity.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Issues related to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - Competitive Bidding Relief Act (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; Issues related to H.R. 2902/S.1406 - SOAR Act of 2025; Issues related to S.4037 Diabetes Act.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Continued to meet with congressional offices following NCARTs annual Fly In. Met with members of Congress/staff on the following issues: Supported timely wheelchair repairs legislation that is currently being drafted in the Senate. Supported S.247 and H.R.1703, Improving access to lightweight carbon fiber and titanium wheelchairs will allow individuals with mobility challenges to choose the wheelchair that is best suited for their medical, functional, and lifestyle needs and preferences, without increasing costs to the Medicare program. https://www.congress.gov/bill/119th-congress/house-bill/1703/all-info Advocated for Medicare coverage of power wheelchairs standing systems. Advocated for restoring federal appropriations for the Department of Defenses Spinal Cord Injury Research Program (SCIRP). United Spinal supported S.Res.440 - A resolution designating September 2025 as National Spinal Cord Injury Awareness Month. United Spinal continued to advocate for H.R. 4206, the CONNECT for Health Act. United Spinal continues to advocate with members of Congress for increased federal funding for the Spinal Cord Injury Model Systems as well as the Burn Model Systems and the Traumatic Brain Injury Model Systems. Increased funding at all three Model Systems, including the Model Systems Knowledge Translation Center is needed to translate data, research, and clinical knowledge into resources to benefit the SCI, TBI and burn injury communities. United Spinal continues to advocate about the concerns we have about the major restructuring of the Department of Health and Human Services programs. We want to make sure that critical programs, services, and funding for the disability and aging communities, such as the Centers for Independent Living, Home and Community-Based Services and the National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR) are not negatively impacted. Advocated for Congress extending the current telehealth provisions before the last deadline and also support H.R. 1614 to make physical therapists and occupational therapists permanently authorized providers of telehealth under Medicare. H.R. 1614, the Expand Practitioners Eligible to Furnish Telehealth Services Under the Medicare Program Act, introduced by Representatives Mike Kelly (R-PA), Mike Thompson (D-CA), and Adrian Smith (R-NE) has bipartisan support to eliminate the need for continued extensions, instructing Centers for Medicare and Medicaid Services to permanently adopt the temporary waiver of restrictions on payment for telehealth services delivered by physical therapists, occupational therapists, and other qualified healthcare. United Spinal, as a member of the Disability Rehabilitation Research Coalition, along with numerous other disability organizations, signed onto a letter to the bipartisan Senate leadership. The letter read in part, The undersigned members of the Disability and Rehabilitation Research Coalition (DRRC) write to express our strong support for passage of the bipartisan Senate Committee on Appropriations Labor, Health and Human Services, Education and Related Agencies (L-HHS) fiscal year (FY) 2026 appropriations bill that includes sustained investment in disability and medical rehabilitation research programs that greatly benefit Americans living with disabilities. We urge you to fully fund these programs for the remainder of FY 2026 to continue the research thatdrives innovation in assistive technologies, informs evidence-based policies, advances medical treatments, and improves quality of life for the more than 70 million Americans living with disabilities. The letter may be reviewed at: https://drrc-coalition.org/wp-content/uploads/2025/11/drrc-letter-11.25.2025.pdf United Spinal participated in and supported the Administration for Community Livings (ACLs) The Power of Caregivers for a Healthy America: Building a Better Future Together event on Tuesday, November 18, 2025. Secretary Kennedy and Secretary Collins from the Department of Veterans Affairs also attended. As followup, United Spinal policy staff reached out to the Administration for Community Living staff to express our interest in collaborating with the Administration on its AI Caregiving Challenge that was announced at the event on how we can help involve our community in the challenge. United Spinal, along with numerous other organizations submitted a letter to the bipartisan leadership of the House of Representatives and the Senate. United Spinal has been advocating for appropriations being restored and continued for the Spinal Cord Injury Research Program historically funded through the Congressionally Directed Medical Research Programs (CDMRP). The letter read in part, we urge you to work toward the enactment of the fiscal year (FY) 2026 Defense Appropriations Act, to ensure full funding levels for the Defense Health Research Programs, including the Congressionally Directed Medical Research Programs (CDMRP). We collectively represent millions of American veterans, military retirees, military families, and civilians who benefit from the ongoing research funded by the CDMRP. https://www.hematology.org/-/media/hematology/files/advocacy/testimony-and-correspondence/2025/ash-joins-coalition-of-150-groups-urging-congress-to-enact-the-fy26-defense-appropriations-act.pdf

Medicare NCD on access to power standing systems; Prior authorization reforms to speed access for people with serious disabilities; Service and repair reforms in health programs; HR 5081, Telehealth Modernization Act; HR 2005, DMEPOS Relief Act of 2025; HR 1703 Choices for Increased Mobility Act of 2025

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - Competitive Bidding Relief Act (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; Issues related to H.R. 2902/S.1406 - SOAR Act of 2025.

Client expense: $440,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Issues related to Medicare durable medical equipment competitive bidding. Issues related to competitive bidding and payment rates in non-competitive bidding areas, including H.R. 2005 / S. 2951, the Competitive Bidding Relief Act of 2025. Issues related to titanium/carbon wheelchair upgrades, including S. 247/H.R. 1703, the Choices for Increased Mobility Act of 2025. Issues related to Medicare oxygen therapy services. Issues related to regulatory relief and program integrity.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; H.R.1703, Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - A bill to direct the Secretary of Health and Human Services to provide for certain adjustments to Medicare payment for items of durable medical equipment that were formerly included in round 2021 of the DMEPOS competitive bidding program (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025; H.R. 2902/S.1406 - The SOAR Act.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

United Spinal continues to oppose H.R. 1, the One Big Beautiful Bill Act, for the adverse effects it will have on people with disabilities, especially in cutting Medicaid programs and benefits. United Spinal continues to advocate about the concerns we have about the major restructuring of the Department of Health and Human Services programs. We want to make sure that critical programs, services, and funding for the disability and aging communities, such as the Centers for Independent Living, Home and Community-Based Services and the National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR) are not negatively impacted. Participated in NCARTs annual Fly In. Met with members of Congress/staff on the following issues: Supported timely wheelchair repairs legislation that is currently being drafted in the Senate. Supported S.247 and H.R.1703, Improving access to lightweight carbon fiber and titanium wheelchairs will allow individuals with mobility challenges to choose the wheelchair that is best suited for their medical, functional, and lifestyle needs and preferences, without increasing costs to the Medicare program. https://www.congress.gov/bill/119th-congress/house-bill/1703/all-info Advocated for Medicare coverage of power wheelchairs standing systems. Advocated for restoring federal appropriations for the Department of Defenses Spinal Cord Injury Research Program (SCIRP). Advocated for Congress extending the current telehealth provisions before the last deadline and also support H.R. 1614 to make physical therapists and occupational therapists permanently authorized providers of telehealth under Medicare. H.R. 1614, the Expand Practitioners Eligible to Furnish Telehealth Services Under the Medicare Program Act, introduced by Representatives Mike Kelly (R-PA), Mike Thompson (D-CA), and Adrian Smith (R-NE) has bipartisan support to eliminate the need for continued extensions, instructing Centers for Medicare and Medicaid Services to permanently adopt the temporary waiver of restrictions on payment for telehealth services delivered by physical therapists, occupational therapists, and other qualified healthcare. United Spinal supports H. R. 4475/S. 2329, the Medicare Orthotics and Prosthetics Patient-Centered Care Act. This bipartisan, bicameral bill will ensure Medicare beneficiaries can access the orthotics and prosthetics devices they need. Under current Medicare requirements, beneficiaries are at risk of receiving orthotic and prosthetic devices without the necessary services and customization required for the best use. The bill will clarify the law and permit Medicare beneficiaries who require prosthetics and orthotics to receive these important services. United Spinal advocacy and policy staff met with officials in the Department of Health and Human Services Administration for Community Living to express their concerns about proposed cuts to their budget and proposed departmental reorganization proposals. Staff stressed the importance of programs under the agency that serve people with disabilities. Discussed ways we could collaborate on highlighting the importance of the research completed enhancing peoples daily lives. United Spinal advocates for S. 1261, the CONNECT for Health Act, introduced by Senator Brian Schatz (D-HI) The CONNECT for Health Act will expand coverage of telehealth services through Medicare, make COVID-19 telehealth flexibilities permanent, improve health outcomes, and make it easier for patients to connect with their doctors. Current flexibilities are set to expire on September 30 unless Congress extends them.

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; H.R.1703, Choices for Increased Mobility Act of 2025; H.R.1, One Big Beautiful Bill Act (P.L.119-21).

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); S. 2951 - A bill to direct the Secretary of Health and Human Services to provide for certain adjustments to Medicare payment for items of durable medical equipment that were formerly included in round 2021 of the DMEPOS competitive bidding program (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025.

Client expense: $300,000 · Firm income: Not reported

Issues related to Medicare durable medical equipment competitive bidding. Issues related to competitive bidding and payment rates in non-competitive bidding areas, including H.R. 2005 / S. 2951, the Competitive Bidding Relief Act of 2025. Issues related to titanium/carbon wheelchair upgrades, including S. 247/H.R. 1703, the Choices for Increased Mobility Act of 2025. Issues related to Medicare coverage of non-invasive ventilators. Issues related to regulatory relief and program integrity.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005/S.2951- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; H.R.1703, Choices for Increased Mobility Act of 2025; H.R.1, One Big Beautiful Bill Act.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025.

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; HR 2005 - Competitive Bidding Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R.1703/S.247 - Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to Medicare durable medical equipment competitive bidding and payment rates in non-competitive bidding areas, including H.R. 2005, the Competitive Bidding Relief Act of 2025. Issues related to titanium/carbon wheelchair upgrades, including S. 247/H.R. 1703, the Choices for Increased Mobility Act of 2025. Issues related to Medicare coverage of non-invasive ventilators. Issues related to regulatory relief and program integrity.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

HR 1703 Payment for manual mobility devices under Part B of the Medicare program; HR 1968 the Full Year Continuing Appropriations and Extensions Act of 2025

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; H.R.1703, Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including H.R. 2005, the Competitive Bidding Relief Act of 2025. Issues related to titanium/carbon wheelchair upgrades, including S. 247/H.R. 1703, the Choices for Increased Mobility Act of 2025. Issues related to Medicare coverage of non-invasive ventilators.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; H.R. 2005- DMEPOS Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R. 1703/S. 247 - Choices for Increased Mobility Act of 2025.

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to Medicare titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; HR 2005 - Competitive Bidding Relief Act of 2025 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); H.R.1703/S.247 - Choices for Increased Mobility Act of 2025.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE