UNITED SPINAL ASSOCIATION

United Spinal as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition supported S. 3988, the Veterans Spinal Trauma Access to New Devices (STAND) Act and earlier in the year we supported the House version, H.R. 6835. This bipartisan legislation would direct the Secretary of Veterans Affairs to offer annual preventative health evaluations to veterans with spinal cord injuries and disorders and increase access to state-of-the-art assistive mobility technologies, such as Exoskeletal systems and other neuromodulation technologies, which allow paralyzed veterans the ability to improve their function and even walk again.

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Matched citations: H.R. 6835

United Spinals SecureRide Coalition advocated for the wheelchair securement research study provision in H. R. 7389, the Motor Vehicle Safety Modernization Act. United Spinals SecureRide Coalition met with Department of Transportation officials to advocate for safe and independent wheelchair securement across all modes of transportation. United Spinal, along with other disability advocates from organizations and communities across the United States who are committed to advancing mobility, independence, and full community participation for people with disabilities, wrote to the leadership of the Federal Transit Administration to support the continued modernization of accessible transportation and ADA paratransit services. The letter read in part, Accessible transportation remains one of the most important gateways to opportunity-enabling individuals to travel to employment, education, healthcare, and civic life. United Spinal discussed provisions of H.R.8128, the Same-Day Paratransit Innovation Act, with congressional staff. United Spinal, through our SecureRide Coalition discussed disability accessibility issues with the Autonomous Vehicle Industry Association ("AVIA") in reference to its statement for the record regarding the Subcommittee on Surface Transportation, Freight, Pipelines, and Safety hearing, "The Need for Speed: How Technological Advances are Driving Transportation Innovation. United Spinal advocated for accessibility provisions to be included in H. R. 8870, the BUILD America 250 Act. United Spinal advocated for the development of an autonomous wheelchair securement system as a co-lead in our SecureRide Coalition with the Department of Transportation. United Spinal, as a co-lead of our SecureRide Coalition submitted an application to participate in the Department of Transportations SecureRide Coalition's submission Roadway Safety Innovation Expo. United Spinal Associations SecureRide Coalition wrote to the bipartisan leadership of the House Energy and Commerce Committee and it Commerce, Manufacturing and Trade Subcommittee to support the automated wheelchair securement research provision included in the amendment in the nature of a substitute for H. R. 7389, the Motor Vehicle Modernization Act, filed in advance of the full committee markup on Thursday, May 21, 2026, at 10:00 a.m. (ET) as the motor vehicle safety title of the upcoming surface transportation reauthorization measure. The measure addresses a major challenge to fulfilling wheelchair users safe and independent transportation needs. United Spinal, along with numerous other stakeholders wrote to the bipartisan leadership and membership of the House Energy and Commerce Committee and the Subcommittee on Commerce, Manufacturing and Trade to voice our support for the progress made on the SELF DRIVE Act, which was introduced by Representative Bob Latta. The letter read in part, the SELF DRIVE Act would help ensure that millions of Americans are able to access the benefits of autonomous vehicles (A Vs), which provide safer roads, greater supply chain resilience, create new economic and enhanced accessibility opportunities. United Spinal submitted comments to the Administrator of the National Highway Traffic Safety Administration supporting Zooxs petition for a temporary exemption from various requirements of the Federal Motor Vehicle Safety Standards (FMVSS) for an automated driving system (ADS) - equipped vehicle, Docket No. NHTSA-2025-0523. The comments read in part, We recognize that achieving these benefits requires careful attention to accessibility standards, inclusive design, and equal access to purpose-built wheelchair accessible autonomous vehicle deployment. With proper planning and regulation, Zoox can expand opportunities for independence, employment, healthcare access, and civic and social engagement, thereby improving the quality of life for people with spinal cord injuries and other mobility challenges. We respectfully request that you support Zooxs petition, Docket No. NHTSA-2025-0523, to enable the safe, federally supervised commercial operation of its all-electric autonomous vehicles. United Spinal, as a member of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force signed onto a letter responding to the request for public comments on the Zoox application for a temporary exemption from various requirements of the Federal Motor Vehicle Safety Standards (FMVSS) for an automated driving system (ADS) - equipped vehicle, NHTSA-2025-0523-0003. The Comments strongly urged, the National Highway Traffic Safety Administration (NHTSA) to compel Zoox to operate a vehicle that is fully accessible for people with disabilities, consistent with the public interest. Given NHTSAs safety mandate and mission, it is essential to integrate accessibility into exemption approvals because it is inextricably linked to the safety of people with disabilities. United Spinal, along with numerous other disability organizations, wrote to the leadership of the Federal Transit Administration leadership about the need for modernizing paratransit services. The letter read in part, In particular, we encourage the FTA to continue advancing regulatory guidance and policy interpretations that support modernization of paratransit services and allow transit agencies to incorporate new mobility solutions-including on-demand service models and partnerships with ride share and TNC providers-into the ADA paratransit ecosystem. Where existing regulatory flexibilities exist, additional clarity and encouragement from the FTA could help agencies confidently expand these models in ways that enhance service for rider. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with Administration for Community Living officials. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with Access Board officials. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with National Council on Disability officials. United Spinal continues to advocate for H.R. 4116, the Disability Access to Transportation Act (DATA) Paratransit one stop and data collection pilot program. The bill would establish an extra stop per trip program for passengers using paratransit serves and enhance data collection for paratransit programs to increase accessible transportation for individuals with disabilities.

Client expense: — · Firm income: —

Matched citations: H. R. 7389

United Spinals SecureRide Coalition advocated for the wheelchair securement research study provision in H. R. 7389, the Motor Vehicle Safety Modernization Act. United Spinals SecureRide Coalition met with Department of Transportation officials to advocate for safe and independent wheelchair securement across all modes of transportation. United Spinal, along with other disability advocates from organizations and communities across the United States who are committed to advancing mobility, independence, and full community participation for people with disabilities, wrote to the leadership of the Federal Transit Administration to support the continued modernization of accessible transportation and ADA paratransit services. The letter read in part, Accessible transportation remains one of the most important gateways to opportunity-enabling individuals to travel to employment, education, healthcare, and civic life. United Spinal discussed provisions of H.R.8128, the Same-Day Paratransit Innovation Act, with congressional staff. United Spinal, through our SecureRide Coalition discussed disability accessibility issues with the Autonomous Vehicle Industry Association ("AVIA") in reference to its statement for the record regarding the Subcommittee on Surface Transportation, Freight, Pipelines, and Safety hearing, "The Need for Speed: How Technological Advances are Driving Transportation Innovation. United Spinal advocated for accessibility provisions to be included in H. R. 8870, the BUILD America 250 Act. United Spinal advocated for the development of an autonomous wheelchair securement system as a co-lead in our SecureRide Coalition with the Department of Transportation. United Spinal, as a co-lead of our SecureRide Coalition submitted an application to participate in the Department of Transportations SecureRide Coalition's submission Roadway Safety Innovation Expo. United Spinal Associations SecureRide Coalition wrote to the bipartisan leadership of the House Energy and Commerce Committee and it Commerce, Manufacturing and Trade Subcommittee to support the automated wheelchair securement research provision included in the amendment in the nature of a substitute for H. R. 7389, the Motor Vehicle Modernization Act, filed in advance of the full committee markup on Thursday, May 21, 2026, at 10:00 a.m. (ET) as the motor vehicle safety title of the upcoming surface transportation reauthorization measure. The measure addresses a major challenge to fulfilling wheelchair users safe and independent transportation needs. United Spinal, along with numerous other stakeholders wrote to the bipartisan leadership and membership of the House Energy and Commerce Committee and the Subcommittee on Commerce, Manufacturing and Trade to voice our support for the progress made on the SELF DRIVE Act, which was introduced by Representative Bob Latta. The letter read in part, the SELF DRIVE Act would help ensure that millions of Americans are able to access the benefits of autonomous vehicles (A Vs), which provide safer roads, greater supply chain resilience, create new economic and enhanced accessibility opportunities. United Spinal submitted comments to the Administrator of the National Highway Traffic Safety Administration supporting Zooxs petition for a temporary exemption from various requirements of the Federal Motor Vehicle Safety Standards (FMVSS) for an automated driving system (ADS) - equipped vehicle, Docket No. NHTSA-2025-0523. The comments read in part, We recognize that achieving these benefits requires careful attention to accessibility standards, inclusive design, and equal access to purpose-built wheelchair accessible autonomous vehicle deployment. With proper planning and regulation, Zoox can expand opportunities for independence, employment, healthcare access, and civic and social engagement, thereby improving the quality of life for people with spinal cord injuries and other mobility challenges. We respectfully request that you support Zooxs petition, Docket No. NHTSA-2025-0523, to enable the safe, federally supervised commercial operation of its all-electric autonomous vehicles. United Spinal, as a member of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force signed onto a letter responding to the request for public comments on the Zoox application for a temporary exemption from various requirements of the Federal Motor Vehicle Safety Standards (FMVSS) for an automated driving system (ADS) - equipped vehicle, NHTSA-2025-0523-0003. The Comments strongly urged, the National Highway Traffic Safety Administration (NHTSA) to compel Zoox to operate a vehicle that is fully accessible for people with disabilities, consistent with the public interest. Given NHTSAs safety mandate and mission, it is essential to integrate accessibility into exemption approvals because it is inextricably linked to the safety of people with disabilities. United Spinal, along with numerous other disability organizations, wrote to the leadership of the Federal Transit Administration leadership about the need for modernizing paratransit services. The letter read in part, In particular, we encourage the FTA to continue advancing regulatory guidance and policy interpretations that support modernization of paratransit services and allow transit agencies to incorporate new mobility solutions-including on-demand service models and partnerships with ride share and TNC providers-into the ADA paratransit ecosystem. Where existing regulatory flexibilities exist, additional clarity and encouragement from the FTA could help agencies confidently expand these models in ways that enhance service for rider. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with Administration for Community Living officials. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with Access Board officials. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with National Council on Disability officials. United Spinal continues to advocate for H.R. 4116, the Disability Access to Transportation Act (DATA) Paratransit one stop and data collection pilot program. The bill would establish an extra stop per trip program for passengers using paratransit serves and enhance data collection for paratransit programs to increase accessible transportation for individuals with disabilities.

Client expense: — · Firm income: —

Matched citations: H.R.8128

United Spinal with other stakeholders discussed with members of Congress introducing legislation to delay the implementation of competitive bidding for ostomy and urological supplies under the Medicare program. United Spinal, along with other members of the Coalition to Preserve Rehabilitation (CPR), submitted comments to the administrator of the Centers for Medicare & Medicaid Services (CMS) in response to Fiscal Year 2027 Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Proposed Rule (proposed rule), (CMS-1845-P). The comments read in part, Our comments focus on key provisions of the proposed rule-including proposed updates impacting IRF coverage and documentation, proposed changes to the IRF Quality Reporting Program, proposed updates to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, and responses to the various requests for information included in the proposed rule-with the goal of ensuring that Medicare beneficiaries continue to have access to the full range of medically necessary rehabilitation services, including those provided in inpatient rehabilitation hospitals. United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the administrator of the Centers for Medicare and Medicaid Services (CMS) requesting a meeting to discuss the status of the long-pending National Coverage Analysis (NCA) for standing systems in Group 3 power wheelchairs. The letter read in part, We strongly urge CMS to proceed expeditiously with opening this NCA for public comment without further delay. As the 36th Anniversary of the Americans with Disabilities Act (ADA) approaches on July 26th, we believe there is no better way to celebrate the successes of this landmark law for people with disabilities over the past three and a half decades than for CMS to open this critically important NCA to address the mobility needs of individuals with disabilities. United Spinal, along with numerous other organizations, signed onto comments from the Not Dead Yet, a grassroots disability rights organization that opposes assisted suicide and Euthanasia. The comments were in response to a notice: Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements The comments in part read, appreciates the opportunity to respond to the Centers for Medicare and Medicaid ServicesNot Dead Yet supports CMS intent to improve transparency and institute data guardrails for hospice care. This will help in the gathering of important data on U.S. patients as the population ages, potentially increasing the demand for hospice options. Not Dead Yets comments, since we are not hospice care providers, primarily introduce additional issues related to assisted suicide and palliative care. United Spinal, along with numerous other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the bipartisan leadership of the Congressional Vision Caucus to bring to their attention a Medicare regulation-the Medicare Low Vision Aid Exclusion at 42 C.F.R. 411.15(b)-that significantly limits beneficiary access to technologies and devices essential to the treatment of low vision. The letter read in part, We respectfully request your support in encouraging the Centers for Medicare and Medicaid Services (CMS) to rescind that outdated and overly broad regulation. Specifically, we request that you send a bipartisan Congressional sign-on letter to CMS, as well as a Dear Colleague letter to garner co-signers supporting this effort. United Spinal continues to oppose the Centers for Medicare and Medicaid Services rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program which will harm people who depend upon these supplies to live and will increase healthcare costs. It may conflict with the Presidents directives on deregulation, trade, and domestic industrial strength. United Spinal continues advocating for Medicare coverage of power wheelchairs standing systems. United Spinal supports legislation introduced by U.S. Representative Ayanna Pressley (D-MA-07), H. R. 9364, the FAST Repairs for Wheelchairs Act, that would eliminate prior authorization requirements for Complex Rehabilitation Technology (CRT) wheelchair maintenance and repairs under the Medicare Advantage (MA) program, aligning MA with traditional Medicare, which generally does not impose these barriers. United Spinal policy staff met with Centers for Medicare and Medicaid Services officials to advocate against implementing the agencys final rule about competitively bidding urological and ostomy supplies: The Centers for Medicare & Medicaid Services (CMS) is making some important changes in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) so that we can protect the Medicare Trust Funds and lower copays for beneficiaries. For more details, refer to the Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) displayed in the Federal Register on November 28, 2025. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition met with officials from the Office of Management and Budget to advocate against the Centers for Medicare and Medicaid Services rule about competitively bidding urological and ostomy supplies. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) in strong opposition to the proposed revisions to the Local Coverage Determination (LCD) DL33789, which would restrict Medicare coverage for certain power mobility devices, specifically, Group 2 standard power wheelchairs with seat elevation systems but without complex rehabilitative technology (CRT) capability. If finalized, this restriction in access to these critical devices would negatively impact Medicare beneficiaries who rely on such features to reach, transfer, and perform or participate in Mobility Related Activities of Daily Living (MRADLs) in their homes, which is the standard for coverage under the power wheelchair and seat elevation National Coverage Determination. United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, submitted comments to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) on the proposed Local Coverage Determination (LCD) for Wheelchair Options/Accessories (DL33792). The ITEM Coalition strongly opposes the proposed determination that power seat elevation systems used with standard, non-complex rehabilitation technology (CRT) power wheelchairs are not reasonable and necessary, and urge the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) to reconsider and withdraw this proposed LCD as soon as possible. For the reasons outlined below, if finalized, this change in policy would significantly restrict access to a critical functional mobility technology for Medicare beneficiaries who rely on power wheelchairs to perform mobility-related activities of daily living (MRADLs) within the home, which is the standard for coverage under the power wheelchair and seat elevation National Coverage Determinations. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the Centers for Medicare and Medicaid Services to reiterate significant concerns with the Agencys decision to include ostomy and urological supplies in the next round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Combined with the implementation of a national Remote Item Delivery (RID) program for distributing these items to Medicare beneficiaries, this policy represents a fundamental shift away from patient-centered, clinically appropriate care for individuals with disabilities and complex medical needs. United Spinal signed onto a letter, along with 358 members of the Disability and Aging Collaborative (DAC), the Health and Long Term Services and Supports (LTSS) Taskforces of the Consortium for Constituents with Disabilities (CCD), and allied organizations to urge the bipartisan, bicameral leadership of the Congress to exclude any funding cuts or harmful changes to Medicaid from any budget reconciliation or other legislation. The letter read in part, Medicaid is our communities lifeline, and that lifeline just suffered the largest cut in funding since its inception. We cannot afford any further cuts, and we urge Congress to prioritize reinvesting in Medicaid. United Spinal, along with other members of the Coalition to Preserve Rehabilitation, wrote in strong support for H.R. 8375, the Medicare Advantage Improvement Act to its bipartisan sponsors. Medicare Advantage (MA) increasingly serves Medicare beneficiaries with complex, disabling conditions who depend on timely access in medical rehabilitation services of all kinds, including inpatient rehabilitation. However, persistent utilization management barriers-including prior authorization delays, inappropriate denials, and disruptions in care-continue to impede access to medically necessary rehabilitation services and undermine patient outcomes. United Spinal, along with other members of the Coalition to Preserve Rehabilitation, wrote in strong support for S. 4384, the Medicare Advantage Improvement Act toots bipartisan sponsors. Medicare Advantage (MA) increasingly serves Medicare beneficiaries with complex, disabling conditions who depend on timely access in medical rehabilitation services of all kinds, including inpatient rehabilitation facility (IRF) care, to achieve optimal recovery and maintain independence. However, persistent utilization management barriers-including prior authorization delays, inappropriate denials, and disruptions in care-continue to impede access to medically necessary rehabilitation services and undermine patient outcomes.

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Matched citations: H.R. 8375

United Spinals SecureRide Coalition advocated for the wheelchair securement research study provision in H. R. 7389, the Motor Vehicle Safety Modernization Act. United Spinals SecureRide Coalition met with Department of Transportation officials to advocate for safe and independent wheelchair securement across all modes of transportation. United Spinal, along with other disability advocates from organizations and communities across the United States who are committed to advancing mobility, independence, and full community participation for people with disabilities, wrote to the leadership of the Federal Transit Administration to support the continued modernization of accessible transportation and ADA paratransit services. The letter read in part, Accessible transportation remains one of the most important gateways to opportunity-enabling individuals to travel to employment, education, healthcare, and civic life. United Spinal discussed provisions of H.R.8128, the Same-Day Paratransit Innovation Act, with congressional staff. United Spinal, through our SecureRide Coalition discussed disability accessibility issues with the Autonomous Vehicle Industry Association ("AVIA") in reference to its statement for the record regarding the Subcommittee on Surface Transportation, Freight, Pipelines, and Safety hearing, "The Need for Speed: How Technological Advances are Driving Transportation Innovation. United Spinal advocated for accessibility provisions to be included in H. R. 8870, the BUILD America 250 Act. United Spinal advocated for the development of an autonomous wheelchair securement system as a co-lead in our SecureRide Coalition with the Department of Transportation. United Spinal, as a co-lead of our SecureRide Coalition submitted an application to participate in the Department of Transportations SecureRide Coalition's submission Roadway Safety Innovation Expo. United Spinal Associations SecureRide Coalition wrote to the bipartisan leadership of the House Energy and Commerce Committee and it Commerce, Manufacturing and Trade Subcommittee to support the automated wheelchair securement research provision included in the amendment in the nature of a substitute for H. R. 7389, the Motor Vehicle Modernization Act, filed in advance of the full committee markup on Thursday, May 21, 2026, at 10:00 a.m. (ET) as the motor vehicle safety title of the upcoming surface transportation reauthorization measure. The measure addresses a major challenge to fulfilling wheelchair users safe and independent transportation needs. United Spinal, along with numerous other stakeholders wrote to the bipartisan leadership and membership of the House Energy and Commerce Committee and the Subcommittee on Commerce, Manufacturing and Trade to voice our support for the progress made on the SELF DRIVE Act, which was introduced by Representative Bob Latta. The letter read in part, the SELF DRIVE Act would help ensure that millions of Americans are able to access the benefits of autonomous vehicles (A Vs), which provide safer roads, greater supply chain resilience, create new economic and enhanced accessibility opportunities. United Spinal submitted comments to the Administrator of the National Highway Traffic Safety Administration supporting Zooxs petition for a temporary exemption from various requirements of the Federal Motor Vehicle Safety Standards (FMVSS) for an automated driving system (ADS) - equipped vehicle, Docket No. NHTSA-2025-0523. The comments read in part, We recognize that achieving these benefits requires careful attention to accessibility standards, inclusive design, and equal access to purpose-built wheelchair accessible autonomous vehicle deployment. With proper planning and regulation, Zoox can expand opportunities for independence, employment, healthcare access, and civic and social engagement, thereby improving the quality of life for people with spinal cord injuries and other mobility challenges. We respectfully request that you support Zooxs petition, Docket No. NHTSA-2025-0523, to enable the safe, federally supervised commercial operation of its all-electric autonomous vehicles. United Spinal, as a member of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force signed onto a letter responding to the request for public comments on the Zoox application for a temporary exemption from various requirements of the Federal Motor Vehicle Safety Standards (FMVSS) for an automated driving system (ADS) - equipped vehicle, NHTSA-2025-0523-0003. The Comments strongly urged, the National Highway Traffic Safety Administration (NHTSA) to compel Zoox to operate a vehicle that is fully accessible for people with disabilities, consistent with the public interest. Given NHTSAs safety mandate and mission, it is essential to integrate accessibility into exemption approvals because it is inextricably linked to the safety of people with disabilities. United Spinal, along with numerous other disability organizations, wrote to the leadership of the Federal Transit Administration leadership about the need for modernizing paratransit services. The letter read in part, In particular, we encourage the FTA to continue advancing regulatory guidance and policy interpretations that support modernization of paratransit services and allow transit agencies to incorporate new mobility solutions-including on-demand service models and partnerships with ride share and TNC providers-into the ADA paratransit ecosystem. Where existing regulatory flexibilities exist, additional clarity and encouragement from the FTA could help agencies confidently expand these models in ways that enhance service for rider. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with Administration for Community Living officials. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with Access Board officials. United Spinal advocated for its SecureRide Coalition wheelchair securement standard efforts with National Council on Disability officials. United Spinal continues to advocate for H.R. 4116, the Disability Access to Transportation Act (DATA) Paratransit one stop and data collection pilot program. The bill would establish an extra stop per trip program for passengers using paratransit serves and enhance data collection for paratransit programs to increase accessible transportation for individuals with disabilities.

Client expense: — · Firm income: —

Matched citations: H. R. 8870

United Spinal with other stakeholders discussed with members of Congress introducing legislation to delay the implementation of competitive bidding for ostomy and urological supplies under the Medicare program. United Spinal, along with other members of the Coalition to Preserve Rehabilitation (CPR), submitted comments to the administrator of the Centers for Medicare & Medicaid Services (CMS) in response to Fiscal Year 2027 Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Proposed Rule (proposed rule), (CMS-1845-P). The comments read in part, Our comments focus on key provisions of the proposed rule-including proposed updates impacting IRF coverage and documentation, proposed changes to the IRF Quality Reporting Program, proposed updates to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, and responses to the various requests for information included in the proposed rule-with the goal of ensuring that Medicare beneficiaries continue to have access to the full range of medically necessary rehabilitation services, including those provided in inpatient rehabilitation hospitals. United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the administrator of the Centers for Medicare and Medicaid Services (CMS) requesting a meeting to discuss the status of the long-pending National Coverage Analysis (NCA) for standing systems in Group 3 power wheelchairs. The letter read in part, We strongly urge CMS to proceed expeditiously with opening this NCA for public comment without further delay. As the 36th Anniversary of the Americans with Disabilities Act (ADA) approaches on July 26th, we believe there is no better way to celebrate the successes of this landmark law for people with disabilities over the past three and a half decades than for CMS to open this critically important NCA to address the mobility needs of individuals with disabilities. United Spinal, along with numerous other organizations, signed onto comments from the Not Dead Yet, a grassroots disability rights organization that opposes assisted suicide and Euthanasia. The comments were in response to a notice: Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements The comments in part read, appreciates the opportunity to respond to the Centers for Medicare and Medicaid ServicesNot Dead Yet supports CMS intent to improve transparency and institute data guardrails for hospice care. This will help in the gathering of important data on U.S. patients as the population ages, potentially increasing the demand for hospice options. Not Dead Yets comments, since we are not hospice care providers, primarily introduce additional issues related to assisted suicide and palliative care. United Spinal, along with numerous other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the bipartisan leadership of the Congressional Vision Caucus to bring to their attention a Medicare regulation-the Medicare Low Vision Aid Exclusion at 42 C.F.R. 411.15(b)-that significantly limits beneficiary access to technologies and devices essential to the treatment of low vision. The letter read in part, We respectfully request your support in encouraging the Centers for Medicare and Medicaid Services (CMS) to rescind that outdated and overly broad regulation. Specifically, we request that you send a bipartisan Congressional sign-on letter to CMS, as well as a Dear Colleague letter to garner co-signers supporting this effort. United Spinal continues to oppose the Centers for Medicare and Medicaid Services rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program which will harm people who depend upon these supplies to live and will increase healthcare costs. It may conflict with the Presidents directives on deregulation, trade, and domestic industrial strength. United Spinal continues advocating for Medicare coverage of power wheelchairs standing systems. United Spinal supports legislation introduced by U.S. Representative Ayanna Pressley (D-MA-07), H. R. 9364, the FAST Repairs for Wheelchairs Act, that would eliminate prior authorization requirements for Complex Rehabilitation Technology (CRT) wheelchair maintenance and repairs under the Medicare Advantage (MA) program, aligning MA with traditional Medicare, which generally does not impose these barriers. United Spinal policy staff met with Centers for Medicare and Medicaid Services officials to advocate against implementing the agencys final rule about competitively bidding urological and ostomy supplies: The Centers for Medicare & Medicaid Services (CMS) is making some important changes in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) so that we can protect the Medicare Trust Funds and lower copays for beneficiaries. For more details, refer to the Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) displayed in the Federal Register on November 28, 2025. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition met with officials from the Office of Management and Budget to advocate against the Centers for Medicare and Medicaid Services rule about competitively bidding urological and ostomy supplies. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) in strong opposition to the proposed revisions to the Local Coverage Determination (LCD) DL33789, which would restrict Medicare coverage for certain power mobility devices, specifically, Group 2 standard power wheelchairs with seat elevation systems but without complex rehabilitative technology (CRT) capability. If finalized, this restriction in access to these critical devices would negatively impact Medicare beneficiaries who rely on such features to reach, transfer, and perform or participate in Mobility Related Activities of Daily Living (MRADLs) in their homes, which is the standard for coverage under the power wheelchair and seat elevation National Coverage Determination. United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, submitted comments to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) on the proposed Local Coverage Determination (LCD) for Wheelchair Options/Accessories (DL33792). The ITEM Coalition strongly opposes the proposed determination that power seat elevation systems used with standard, non-complex rehabilitation technology (CRT) power wheelchairs are not reasonable and necessary, and urge the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) to reconsider and withdraw this proposed LCD as soon as possible. For the reasons outlined below, if finalized, this change in policy would significantly restrict access to a critical functional mobility technology for Medicare beneficiaries who rely on power wheelchairs to perform mobility-related activities of daily living (MRADLs) within the home, which is the standard for coverage under the power wheelchair and seat elevation National Coverage Determinations. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the Centers for Medicare and Medicaid Services to reiterate significant concerns with the Agencys decision to include ostomy and urological supplies in the next round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Combined with the implementation of a national Remote Item Delivery (RID) program for distributing these items to Medicare beneficiaries, this policy represents a fundamental shift away from patient-centered, clinically appropriate care for individuals with disabilities and complex medical needs. United Spinal signed onto a letter, along with 358 members of the Disability and Aging Collaborative (DAC), the Health and Long Term Services and Supports (LTSS) Taskforces of the Consortium for Constituents with Disabilities (CCD), and allied organizations to urge the bipartisan, bicameral leadership of the Congress to exclude any funding cuts or harmful changes to Medicaid from any budget reconciliation or other legislation. The letter read in part, Medicaid is our communities lifeline, and that lifeline just suffered the largest cut in funding since its inception. We cannot afford any further cuts, and we urge Congress to prioritize reinvesting in Medicaid. United Spinal, along with other members of the Coalition to Preserve Rehabilitation, wrote in strong support for H.R. 8375, the Medicare Advantage Improvement Act to its bipartisan sponsors. Medicare Advantage (MA) increasingly serves Medicare beneficiaries with complex, disabling conditions who depend on timely access in medical rehabilitation services of all kinds, including inpatient rehabilitation. However, persistent utilization management barriers-including prior authorization delays, inappropriate denials, and disruptions in care-continue to impede access to medically necessary rehabilitation services and undermine patient outcomes. United Spinal, along with other members of the Coalition to Preserve Rehabilitation, wrote in strong support for S. 4384, the Medicare Advantage Improvement Act toots bipartisan sponsors. Medicare Advantage (MA) increasingly serves Medicare beneficiaries with complex, disabling conditions who depend on timely access in medical rehabilitation services of all kinds, including inpatient rehabilitation facility (IRF) care, to achieve optimal recovery and maintain independence. However, persistent utilization management barriers-including prior authorization delays, inappropriate denials, and disruptions in care-continue to impede access to medically necessary rehabilitation services and undermine patient outcomes.

Client expense: — · Firm income: —

Matched citations: H. R. 9364

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.

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Matched citations: H. R. 9364

United Spinal supports legislation that Rep. Dina Titus and Senator Tammy Baldwin introduced, H.R. 9373/S. 4829, the Air Carrier Access Amendment Act (ACAAA) of 2026. As a member of the ACAA Working Group, United Spinal signed onto a letter to the Department of Transportations Secretary, Sean Duffy, requesting updates on the status of DOTs implementation of the disability-related provisions of the FAA Reauthorization Act of 2024 (P.L. 118-63) and urging DOT to meet the requirements specified by Congress. The letter emphasizes the importance of the disability-related provisions. This includes the reauthorization of the Air Carrier Access Act Advisory Committee; data on mishandled wheelchairs; public reports; rulemaking on seating accommodations; the service animal travel pilot program; minimum technology accessibility standards; aisle chair standards; and rulemaking on in-flight entertainment. The letter also urges DOT to uphold the Wheelchair User Rule's improved training requirements effective June 17, 2026. United Spinal met with members of Congress to discuss the implementation of accessibility provisions in the FAA Reauthorization Act of 2024.

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Matched citations: S. 4829

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.

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Matched citations: S. 247, S.247

United Spinal as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition supported S. 3988, the Veterans Spinal Trauma Access to New Devices (STAND) Act and earlier in the year we supported the House version, H.R. 6835. This bipartisan legislation would direct the Secretary of Veterans Affairs to offer annual preventative health evaluations to veterans with spinal cord injuries and disorders and increase access to state-of-the-art assistive mobility technologies, such as Exoskeletal systems and other neuromodulation technologies, which allow paralyzed veterans the ability to improve their function and even walk again.

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Matched citations: S. 3988

United Spinal with other stakeholders discussed with members of Congress introducing legislation to delay the implementation of competitive bidding for ostomy and urological supplies under the Medicare program. United Spinal, along with other members of the Coalition to Preserve Rehabilitation (CPR), submitted comments to the administrator of the Centers for Medicare & Medicaid Services (CMS) in response to Fiscal Year 2027 Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) Proposed Rule (proposed rule), (CMS-1845-P). The comments read in part, Our comments focus on key provisions of the proposed rule-including proposed updates impacting IRF coverage and documentation, proposed changes to the IRF Quality Reporting Program, proposed updates to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, and responses to the various requests for information included in the proposed rule-with the goal of ensuring that Medicare beneficiaries continue to have access to the full range of medically necessary rehabilitation services, including those provided in inpatient rehabilitation hospitals. United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the administrator of the Centers for Medicare and Medicaid Services (CMS) requesting a meeting to discuss the status of the long-pending National Coverage Analysis (NCA) for standing systems in Group 3 power wheelchairs. The letter read in part, We strongly urge CMS to proceed expeditiously with opening this NCA for public comment without further delay. As the 36th Anniversary of the Americans with Disabilities Act (ADA) approaches on July 26th, we believe there is no better way to celebrate the successes of this landmark law for people with disabilities over the past three and a half decades than for CMS to open this critically important NCA to address the mobility needs of individuals with disabilities. United Spinal, along with numerous other organizations, signed onto comments from the Not Dead Yet, a grassroots disability rights organization that opposes assisted suicide and Euthanasia. The comments were in response to a notice: Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements The comments in part read, appreciates the opportunity to respond to the Centers for Medicare and Medicaid ServicesNot Dead Yet supports CMS intent to improve transparency and institute data guardrails for hospice care. This will help in the gathering of important data on U.S. patients as the population ages, potentially increasing the demand for hospice options. Not Dead Yets comments, since we are not hospice care providers, primarily introduce additional issues related to assisted suicide and palliative care. United Spinal, along with numerous other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the bipartisan leadership of the Congressional Vision Caucus to bring to their attention a Medicare regulation-the Medicare Low Vision Aid Exclusion at 42 C.F.R. 411.15(b)-that significantly limits beneficiary access to technologies and devices essential to the treatment of low vision. The letter read in part, We respectfully request your support in encouraging the Centers for Medicare and Medicaid Services (CMS) to rescind that outdated and overly broad regulation. Specifically, we request that you send a bipartisan Congressional sign-on letter to CMS, as well as a Dear Colleague letter to garner co-signers supporting this effort. United Spinal continues to oppose the Centers for Medicare and Medicaid Services rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program which will harm people who depend upon these supplies to live and will increase healthcare costs. It may conflict with the Presidents directives on deregulation, trade, and domestic industrial strength. United Spinal continues advocating for Medicare coverage of power wheelchairs standing systems. United Spinal supports legislation introduced by U.S. Representative Ayanna Pressley (D-MA-07), H. R. 9364, the FAST Repairs for Wheelchairs Act, that would eliminate prior authorization requirements for Complex Rehabilitation Technology (CRT) wheelchair maintenance and repairs under the Medicare Advantage (MA) program, aligning MA with traditional Medicare, which generally does not impose these barriers. United Spinal policy staff met with Centers for Medicare and Medicaid Services officials to advocate against implementing the agencys final rule about competitively bidding urological and ostomy supplies: The Centers for Medicare & Medicaid Services (CMS) is making some important changes in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) so that we can protect the Medicare Trust Funds and lower copays for beneficiaries. For more details, refer to the Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) displayed in the Federal Register on November 28, 2025. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition met with officials from the Office of Management and Budget to advocate against the Centers for Medicare and Medicaid Services rule about competitively bidding urological and ostomy supplies. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) in strong opposition to the proposed revisions to the Local Coverage Determination (LCD) DL33789, which would restrict Medicare coverage for certain power mobility devices, specifically, Group 2 standard power wheelchairs with seat elevation systems but without complex rehabilitative technology (CRT) capability. If finalized, this restriction in access to these critical devices would negatively impact Medicare beneficiaries who rely on such features to reach, transfer, and perform or participate in Mobility Related Activities of Daily Living (MRADLs) in their homes, which is the standard for coverage under the power wheelchair and seat elevation National Coverage Determination. United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, submitted comments to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) on the proposed Local Coverage Determination (LCD) for Wheelchair Options/Accessories (DL33792). The ITEM Coalition strongly opposes the proposed determination that power seat elevation systems used with standard, non-complex rehabilitation technology (CRT) power wheelchairs are not reasonable and necessary, and urge the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) to reconsider and withdraw this proposed LCD as soon as possible. For the reasons outlined below, if finalized, this change in policy would significantly restrict access to a critical functional mobility technology for Medicare beneficiaries who rely on power wheelchairs to perform mobility-related activities of daily living (MRADLs) within the home, which is the standard for coverage under the power wheelchair and seat elevation National Coverage Determinations. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the Centers for Medicare and Medicaid Services to reiterate significant concerns with the Agencys decision to include ostomy and urological supplies in the next round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Combined with the implementation of a national Remote Item Delivery (RID) program for distributing these items to Medicare beneficiaries, this policy represents a fundamental shift away from patient-centered, clinically appropriate care for individuals with disabilities and complex medical needs. United Spinal signed onto a letter, along with 358 members of the Disability and Aging Collaborative (DAC), the Health and Long Term Services and Supports (LTSS) Taskforces of the Consortium for Constituents with Disabilities (CCD), and allied organizations to urge the bipartisan, bicameral leadership of the Congress to exclude any funding cuts or harmful changes to Medicaid from any budget reconciliation or other legislation. The letter read in part, Medicaid is our communities lifeline, and that lifeline just suffered the largest cut in funding since its inception. We cannot afford any further cuts, and we urge Congress to prioritize reinvesting in Medicaid. United Spinal, along with other members of the Coalition to Preserve Rehabilitation, wrote in strong support for H.R. 8375, the Medicare Advantage Improvement Act to its bipartisan sponsors. Medicare Advantage (MA) increasingly serves Medicare beneficiaries with complex, disabling conditions who depend on timely access in medical rehabilitation services of all kinds, including inpatient rehabilitation. However, persistent utilization management barriers-including prior authorization delays, inappropriate denials, and disruptions in care-continue to impede access to medically necessary rehabilitation services and undermine patient outcomes. United Spinal, along with other members of the Coalition to Preserve Rehabilitation, wrote in strong support for S. 4384, the Medicare Advantage Improvement Act toots bipartisan sponsors. Medicare Advantage (MA) increasingly serves Medicare beneficiaries with complex, disabling conditions who depend on timely access in medical rehabilitation services of all kinds, including inpatient rehabilitation facility (IRF) care, to achieve optimal recovery and maintain independence. However, persistent utilization management barriers-including prior authorization delays, inappropriate denials, and disruptions in care-continue to impede access to medically necessary rehabilitation services and undermine patient outcomes.

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Matched citations: S. 4384

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.

Client expense: — · Firm income: —

Matched citations: S. Res. 685

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

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Matched citations: H.R. 1614

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

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Matched citations: H.R.1703

Discussing a potential presentation to the Accessible Transportation Research Center on autonomous vehicles impact on the disability community and United Spinals SecureRide Coalitions wheelchair securement work. United Spinal, as a Co-Lead in the SecureRide Coalition, met with Department of Transportation representatives to discuss and advocate for issues related to wheelchair securement during transit. United Spinal is advocating for the research provision for wheelchair securement contained in H.R. 7389, the Motor Vehicle Modernization Act of 2026. United Spinal staff, and numerous other disability organizations, met with the Department of Transportations Office of Aviation Consumer Protection and other officials to discuss disability and accessibility related issues. United Spinal wrote to the bipartisan leadership of the Senate Commerce, Science, and Transportation Committee respectfully requesting that the Senate include a National Autonomous Vehicle (AV) Framework in the upcoming surface transportation reauthorization bill. The letter read in part, The AV moment is upon us. The time to enact a life-saving, life-changing technology national safety baseline and regulatory certainty for new market expansion is now. An AV framework is a critical opportunity for the United States to lead the world in advancing safe mobility technology with the promise to expand freedom and independence for millions of Americans in both rural and urban sectors, especially for the nations 5.5 million wheelchair users. Additionally, stressed the need for research on the modified universal docking integrated geometry (UDIG) RESNA standard to secure users wheelchairs in vehicles, both AVS and vehicles across various modes of transportation, including land, rail and air. United Spinal sent a letter of support to the bipartisan leadership of the House Energy and Commerce Committee, advocating for the automated wheelchair securement research provision in the discussion draft of the Motor Vehicle Modernization Act as the Commerce, Manufacturing and Trades Subcommittee developed the safety title of the upcoming surface transportation reauthorization measure. The letter read in part, As you know, safe automated wheelchair securement has been a significant challenge to the autonomous vehicle industry in developing a purpose-built fully accessible autonomous vehicle (AV). The United Spinal Associations SecureRide Coalition, in a letter to the bipartisan leadership of the Energy and Commerce Committee, supported the automated wheelchair securement research provision included in the discussion draft of the Motor Vehicle Modernization Act as the Commerce, Manufacturing and Trades Subcommittee developed the safety title of the upcoming surface transportation reauthorization measure. The letter read in part, Thank you for addressing a major challenge to fulfilling wheelchair users safe and independent transportation needs. United Spinal, along with numerous other organizations, sent a letter of support to the bipartisan leadership of the House Energy and Commerce Committee for the progress made on the bipartisan SELF DRIVE Act discussion draft. The letter read in part, The SELF DRIVE Act would help ensure that millions of Americans are able to access the benefits of autonomous vehicles (A Vs), which provide safer roads, greater supply chain resilience, create new economic and enhanced accessibility opportunities. United Spinal and other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted a letter for the record for the February 10, 2026, markup of legislation to strengthen motor vehicle safety and advance U.S. automative leadership. To allow people with disabilities to benefit from autonomous vehicles (AVs), the, vehicles must accommodate passengers to remain in their personal wheelchairs, the human machine interface (HMI) must be accessible for people with sensory and cognitive disabilities, vehicles must be able to detect all types of disabled pedestrians, and disabled passengers and pedestrians rights and access to courts must be protected. We acknowledge additional research into automated securement is proposed in the Motor Vehicle Modernization Act and that vulnerable road user detection, including pedestrians and wheelchair users, is proposed in the Magnus White Safe Streets for Everyone Act. We support the automated securement provision and the Magnus White bill. https://c-c-d.org/fichiers/EC-AV-Markup-Disability-Letter-for-the-Record-020926-Final.pdf United Spinal and other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted comments for the record for the January 13, 2026 hearing on strengthening motor vehicle safety and cementing U.S. automative leadership. The comments read in part, While the question was asked of witnesses how the draft legislation would ensure access for people with disabilities, no concrete answers were given. To ensure people with disabilities benefit from autonomous vehicles (AVs) the vehicles must accommodate passengers who remain in their wheelchairs, the human machine interface (HMI) must be accessible for people with sensory and cognitive disabilities and AVs must be able to detect all types of disabled pedestrians. We acknowledge additional research into automated securement is proposed in the Motor Vehicle Modernization Act and vulnerable road user detection is proposed in the Safe Streets for Everyone Act. Access and safety for disabled passengers is not addressed in the SELF DRIVE Act of 2026. To ensure American leadership in AVs and automated driving system (ADS)-equipped vehicles, we urge you to consider and prioritize the safety and access needs of disabled passengers and pedestrians. United Spinal and other organizations as members of the United for Autonomy coalition, which has come together in recognition of the significant benefits that autonomous vehicles (AVs) will bring the American public and to encourage policymakers to set in place a federal policy framework on Avs, wrote to the bipartisan leadership of the Senate Committee on Commerce, Science, and Transportation. The letter read in part, It is imperative that the United States create a federal policy framework on A Vs. In recent years, U.S. states have set the pace on AV policy, and it is long past time for the federal government to establish federal policy that supports safe autonomous deployment. We believe that such a framework will help ensure that millions of Americans are able to access the benefits of autonomous vehicles, which provide safer roads, greater supply chain resilience, and create new economic and enhanced accessibility opportunities for people with disabilities. https://www.acb.org/sites/default/files/United%20for%20Autonomy%20letter%20to%20Senate%20Commerce%20hearing%20(1).pdf United Spinal supported the testimony of Jeff Farrah, Chief Executive Officer, Autonomous Vehicle Association before the U. S. Senate Committee on Commerce, Science, and Transportation on February 4, 2026, entitled hit the road, Mac: The Future of Self Driving Cars that dealt with wheelchair securement in vehicles. https://cdn.prod.website-files.com/67ee365c25e6530594bd40c2/6983967231abcd56d42a55f4_Jeff%20Farrah%20-%20AVIA%20-%20Written%20Testimony%20-%20Hit%20the%20Road%20Mac.pdf United Spinal, along with numerous other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted a letter for the record for the February 4, 2026, hearing titled Hit the Road, Mac: The Future of Self-Driving Cars. The letter read in part, As noted in the hearing announcement, autonomous vehicles (AVs) have the potential to save lives and could also significantly expand mobility and independence for people with disabilities who are unable to drive, improving access to employment, healthcare, and the community. https://c-c-d.org/fichiers/Commerce-AV-Hearing-Disability-Letter-for-the-Record-Final020426.pdf United Spinal, along with numerous other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted a letter for the record for the February 10, 2026, markup of legislation before the Subcommittee on Commerce, Manufacturing and Trade to strengthen motor vehicle safety and advance U.S. automative leadership. The letter read in part, to allow people with disabilities to benefit from autonomous vehicles (AVs), the vehicles must accommodate passengers to remain in their personal wheelchairs, the human machine interface (HMI) must be accessible for people with sensory and cognitive disabilities, vehicles must be able to detect all types of disabled pedestrians, and disabled passengers and pedestrians rights and access to courts must be protected. https://c-c-d.org/fichiers/EC-AV-Markup-Disability-Letter-for-the-Record-020926-Final.pdf United Spinal submitted comments in response to the Department of Transportations request for contributions to the Transportation Research and Development Strategic Plan, DOT-OST-2025-2085. The comments read in part, For the nations 5.5 million wheelchair users, strategic research and development planning can ultimately help in meeting daily transportation needs. That includes fulfilling employment or education needs, healthcare and fitness needs, but also civic and recreational opportunities. It will enrich families and social activities. All this stimulates economic benefits to the general economy. https://downloads.regulations.gov/DOT-OST-2025-2085-0075/attachment_1.pdf United Spinal continues to advocate for H.R. 4116 Disability Access to Transportation Act (DATA) Paratransit one stop and data collection pilot program. The bill would establish an extra stop per trip program for passengers using paratransit serves and enhance data collection for paratransit programs to increase accessible transportation for individuals with disabilities. https://www.congress.gov/bill/119th-congress/house-bill/4116/

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Matched citations: H.R. 4116

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

Client expense: — · Firm income: —

Matched citations: H.R. 4206

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

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Matched citations: H.R. 5343, h.r.5343

United Spinal continues to oppose the Centers for Medicare and Medicaid Services rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program which will harm people who depend upon these supplies to live and will increase healthcare costs. It may conflict with the Presidents directives on deregulation, trade, and domestic industrial strength. United Spinal continues advocating for Medicare coverage of power wheelchairs standing systems. United Spinal and other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, sent a letter of support to the bipartisan leadership of the House Energy and Commerce Committee. The letter read in part, we write to express our 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. We respectfully urge 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 and other members of the Coalition to Preserve Rehabilitation (CPR) and the Habilitation Benefits (HAB) Coalition submitted joint comments on the HHS Notice of Benefit Payment Parameters for the 2027 Plan Year proposed rule (proposed rule), which was published in the Federal Register on February 11, 2026, CMS-98883-P. The joint comments focused on key proposals related to enrollees in need of the essential health benefit (EHB) category of rehabilitation and habilitation services and devices. They addressed historical identification of these benefits as EHBs and discussed our recommendations to eliminate caps in therapy benefits. Also addressed our concerns with the proposed expansion of catastrophic plans that do not require EHB coverage, followed by the proposed rules reversal of policy involving state defrayal of EHB benefits. https://preserverehab.org/wp-content/uploads/2026/03/cpr-hab-coalition-comment-letter-in-response-to-hhs-nbpp-for-2027-proposed-rule-final-version.pdf United Spinal, along with 106 other members of CCDs Long-Term Services and Supports (LTSS), Rights, Health, and Developmental Disabilities, Autism and Family Support Task Forces and the Disability and Aging Collaborative (DAC) and allies responded to the Request for Information (RFI) Related to Comprehensive Regulations to Uncover Suspicious Healthcare, CMS-6098-NC. The letter read part, The undersigned organizations are deeply concerned about the Centers for Medicare & Medicaid Services (CMS) recent actions. Individuals with disabilities and older adults rely on many of the Medicaid services that CMS is targeting in its actions in Minnesota, as well as many of the services that CMS has flagged for investigation in New York, Maine, California, and Florida. When funding for such services is wholesale suspended or frozen, as it has been in Minnesota, Medicaid enrollees are ultimately harmed, not protected. https://downloads.regulations.gov/CMS-2026-0826-0249/attachment_1.pdf

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Matched citations: H.R. 5343, h.r.5343

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

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Matched citations: H.R. 5940, h.r.5940

United Spinal and other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, sent a letter to express support for H.R. 6835, the Veterans Spinal Trauma Access to New Devices (STAND) Act of 2025, to the Chairman of the House Committee on Veterans Affairs and other House sponsors. This bipartisan legislation would direct the Secretary of Veterans Affairs to offer annual preventative health evaluations to veterans with spinal cord injuries and disorders and increase access to state-of-the-art assistive mobility technologies, such as Exoskeletal systems and other neuromodulation technologies, which allow paralyzed veterans the ability to improve their function and even walk again. https://itemcoalition.org/wp-content/uploads/2026/01/item-coalition-support-letter-for-h.r.-6835-the-veterans-stand-act-final.pdf United Spinal and other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition sent a letter to sponsors of S. 3138, the Veterans Supporting Prosthetics Opportunities and Recreational Therapy (SPORT) Act, which would provide coverage under the Department of Veterans Affairs (VA) benefit for prosthetic limbs that veterans with limb loss use to participate in physical activities in order to remain fit, healthy, and as functional as possible to express support. Specifically, this bill would recognize coverage of activity-specific prosthetic limbs as medically necessary under the VA benefit which the ITEM Coalition fully supports. As its title suggests, access to activity-specific prostheses would entail access to the recreational therapy veterans may need to learn how to safely perform these physical activities. https://itemcoalition.org/wp-content/uploads/2026/01/item-letter-of-support-for-s.-3138-the-veterans-sport-act-final.pdf

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Matched citations: H.R. 6835

Discussing a potential presentation to the Accessible Transportation Research Center on autonomous vehicles impact on the disability community and United Spinals SecureRide Coalitions wheelchair securement work. United Spinal, as a Co-Lead in the SecureRide Coalition, met with Department of Transportation representatives to discuss and advocate for issues related to wheelchair securement during transit. United Spinal is advocating for the research provision for wheelchair securement contained in H.R. 7389, the Motor Vehicle Modernization Act of 2026. United Spinal staff, and numerous other disability organizations, met with the Department of Transportations Office of Aviation Consumer Protection and other officials to discuss disability and accessibility related issues. United Spinal wrote to the bipartisan leadership of the Senate Commerce, Science, and Transportation Committee respectfully requesting that the Senate include a National Autonomous Vehicle (AV) Framework in the upcoming surface transportation reauthorization bill. The letter read in part, The AV moment is upon us. The time to enact a life-saving, life-changing technology national safety baseline and regulatory certainty for new market expansion is now. An AV framework is a critical opportunity for the United States to lead the world in advancing safe mobility technology with the promise to expand freedom and independence for millions of Americans in both rural and urban sectors, especially for the nations 5.5 million wheelchair users. Additionally, stressed the need for research on the modified universal docking integrated geometry (UDIG) RESNA standard to secure users wheelchairs in vehicles, both AVS and vehicles across various modes of transportation, including land, rail and air. United Spinal sent a letter of support to the bipartisan leadership of the House Energy and Commerce Committee, advocating for the automated wheelchair securement research provision in the discussion draft of the Motor Vehicle Modernization Act as the Commerce, Manufacturing and Trades Subcommittee developed the safety title of the upcoming surface transportation reauthorization measure. The letter read in part, As you know, safe automated wheelchair securement has been a significant challenge to the autonomous vehicle industry in developing a purpose-built fully accessible autonomous vehicle (AV). The United Spinal Associations SecureRide Coalition, in a letter to the bipartisan leadership of the Energy and Commerce Committee, supported the automated wheelchair securement research provision included in the discussion draft of the Motor Vehicle Modernization Act as the Commerce, Manufacturing and Trades Subcommittee developed the safety title of the upcoming surface transportation reauthorization measure. The letter read in part, Thank you for addressing a major challenge to fulfilling wheelchair users safe and independent transportation needs. United Spinal, along with numerous other organizations, sent a letter of support to the bipartisan leadership of the House Energy and Commerce Committee for the progress made on the bipartisan SELF DRIVE Act discussion draft. The letter read in part, The SELF DRIVE Act would help ensure that millions of Americans are able to access the benefits of autonomous vehicles (A Vs), which provide safer roads, greater supply chain resilience, create new economic and enhanced accessibility opportunities. United Spinal and other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted a letter for the record for the February 10, 2026, markup of legislation to strengthen motor vehicle safety and advance U.S. automative leadership. To allow people with disabilities to benefit from autonomous vehicles (AVs), the, vehicles must accommodate passengers to remain in their personal wheelchairs, the human machine interface (HMI) must be accessible for people with sensory and cognitive disabilities, vehicles must be able to detect all types of disabled pedestrians, and disabled passengers and pedestrians rights and access to courts must be protected. We acknowledge additional research into automated securement is proposed in the Motor Vehicle Modernization Act and that vulnerable road user detection, including pedestrians and wheelchair users, is proposed in the Magnus White Safe Streets for Everyone Act. We support the automated securement provision and the Magnus White bill. https://c-c-d.org/fichiers/EC-AV-Markup-Disability-Letter-for-the-Record-020926-Final.pdf United Spinal and other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted comments for the record for the January 13, 2026 hearing on strengthening motor vehicle safety and cementing U.S. automative leadership. The comments read in part, While the question was asked of witnesses how the draft legislation would ensure access for people with disabilities, no concrete answers were given. To ensure people with disabilities benefit from autonomous vehicles (AVs) the vehicles must accommodate passengers who remain in their wheelchairs, the human machine interface (HMI) must be accessible for people with sensory and cognitive disabilities and AVs must be able to detect all types of disabled pedestrians. We acknowledge additional research into automated securement is proposed in the Motor Vehicle Modernization Act and vulnerable road user detection is proposed in the Safe Streets for Everyone Act. Access and safety for disabled passengers is not addressed in the SELF DRIVE Act of 2026. To ensure American leadership in AVs and automated driving system (ADS)-equipped vehicles, we urge you to consider and prioritize the safety and access needs of disabled passengers and pedestrians. United Spinal and other organizations as members of the United for Autonomy coalition, which has come together in recognition of the significant benefits that autonomous vehicles (AVs) will bring the American public and to encourage policymakers to set in place a federal policy framework on Avs, wrote to the bipartisan leadership of the Senate Committee on Commerce, Science, and Transportation. The letter read in part, It is imperative that the United States create a federal policy framework on A Vs. In recent years, U.S. states have set the pace on AV policy, and it is long past time for the federal government to establish federal policy that supports safe autonomous deployment. We believe that such a framework will help ensure that millions of Americans are able to access the benefits of autonomous vehicles, which provide safer roads, greater supply chain resilience, and create new economic and enhanced accessibility opportunities for people with disabilities. https://www.acb.org/sites/default/files/United%20for%20Autonomy%20letter%20to%20Senate%20Commerce%20hearing%20(1).pdf United Spinal supported the testimony of Jeff Farrah, Chief Executive Officer, Autonomous Vehicle Association before the U. S. Senate Committee on Commerce, Science, and Transportation on February 4, 2026, entitled hit the road, Mac: The Future of Self Driving Cars that dealt with wheelchair securement in vehicles. https://cdn.prod.website-files.com/67ee365c25e6530594bd40c2/6983967231abcd56d42a55f4_Jeff%20Farrah%20-%20AVIA%20-%20Written%20Testimony%20-%20Hit%20the%20Road%20Mac.pdf United Spinal, along with numerous other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted a letter for the record for the February 4, 2026, hearing titled Hit the Road, Mac: The Future of Self-Driving Cars. The letter read in part, As noted in the hearing announcement, autonomous vehicles (AVs) have the potential to save lives and could also significantly expand mobility and independence for people with disabilities who are unable to drive, improving access to employment, healthcare, and the community. https://c-c-d.org/fichiers/Commerce-AV-Hearing-Disability-Letter-for-the-Record-Final020426.pdf United Spinal, along with numerous other members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and friends submitted a letter for the record for the February 10, 2026, markup of legislation before the Subcommittee on Commerce, Manufacturing and Trade to strengthen motor vehicle safety and advance U.S. automative leadership. The letter read in part, to allow people with disabilities to benefit from autonomous vehicles (AVs), the vehicles must accommodate passengers to remain in their personal wheelchairs, the human machine interface (HMI) must be accessible for people with sensory and cognitive disabilities, vehicles must be able to detect all types of disabled pedestrians, and disabled passengers and pedestrians rights and access to courts must be protected. https://c-c-d.org/fichiers/EC-AV-Markup-Disability-Letter-for-the-Record-020926-Final.pdf United Spinal submitted comments in response to the Department of Transportations request for contributions to the Transportation Research and Development Strategic Plan, DOT-OST-2025-2085. The comments read in part, For the nations 5.5 million wheelchair users, strategic research and development planning can ultimately help in meeting daily transportation needs. That includes fulfilling employment or education needs, healthcare and fitness needs, but also civic and recreational opportunities. It will enrich families and social activities. All this stimulates economic benefits to the general economy. https://downloads.regulations.gov/DOT-OST-2025-2085-0075/attachment_1.pdf United Spinal continues to advocate for H.R. 4116 Disability Access to Transportation Act (DATA) Paratransit one stop and data collection pilot program. The bill would establish an extra stop per trip program for passengers using paratransit serves and enhance data collection for paratransit programs to increase accessible transportation for individuals with disabilities. https://www.congress.gov/bill/119th-congress/house-bill/4116/

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Matched citations: H.R. 7389