TIMOTHY KEYSER

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.

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.

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

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

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

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

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.

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

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/

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.

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.

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.

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.

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.

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.

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

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.

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

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

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.

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.

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.

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.

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.

United Spinal, as a member of the Health and Long-Term Services and Supports Task force of the Consortium for Constituents with Disabilities (CCD), the Disability and Aging Collaborative (DAC), and allied organizations wrote to the Administrator of the Centers for Medicare and Medicaid Services to provide feedback on implementation of the new community engagement requirements enacted by the budget reconciliation act of 2025 (H.R. 1). The comments read in part, Congress intended to exempt people with disabilities and their caregivers from the community engagement requirements. With that in mind, we urge the Administration to use guidance and rulemaking to provide maximum protection for people with disabilities, older adults, and caregivers from coverage loss or disruption. The letter may be reviewed at: https://www.c-c-d.org/fichiers/Letter-from-Aging-and-Disability-Organizations-on-Medicaid-Community-Engagement-Requirements.pdf United Spinal supported and urged members of Congress to sign on to a letter to Dr. Mehmet Oz, Administrator, Centers for Medicare & Medicaid Services with concerns about expanding the agencys Competive Bidding Program. The letter read in part, As Members of Congress committed to advancing President Trumps America First agenda, we write to express serious concern that the Centers for Medicare and Medicaid Services proposed rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program may conflict with thePresidents directives on deregulation, trade, and domestic industrial strength. We respectfully urge CMS to pause and re-evaluate these provisions to ensure that they fully align with the Administrations goal of rebuilding American manufacturing, protecting Main Street businesses, and fostering innovation. United Spinal supported and advocated for members of Congress to sign onto a letter submitted țo the Administrator of the Centers for Medicare and Medicaid Services and the Director of the Office of Management and Budget. The letter read in part, We write to express our concerns regarding the Centers for Medicare & Medicaid Services (CMS) proposed Calendar Year (CY) Home Health proposed rules inclusion of ostomy, urological, and tracheostomy supplies in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. We respectfully request that the proposal for inclusion of these products be withdrawn as we believe it would 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. United Spinal, along with numerous other disability organizations and as members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the bipartisan leadership of the House Ways and Means and Energy and Commerce Committees as well as the Senate Finance Committee to encourage the leadership of the Senate and House committees of jurisdiction over the Medicare program to continue working with the Centers for Medicare and Medicaid Services (CMS) to enable Medicare beneficiaries living with disabilities and chronic obesity to access anti-obesity medications (AOMs) through the Medicare Part D program. The ITEM Coalition firmly believes that Medicare beneficiaries living with obesity, especially individuals with mobility impairments, should have equal access to the full continuum of obesity treatment options available to those living with chronic diseases such as diabetes and cardiovascular conditions, conditions where AOMs are already covered. The House letter may be reviewed at: https://itemcoalition.org/wp-content/uploads/2025/11/item-letter-to-congressional-committee-leadership-on-anti-obesity-medications-final.pdf United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition (https://itemcoalition.org/), supported a Coalitions press statement that expressed deep disappointment with a final rule that exposes Medicare patients to the lowest bidder for ostomy and urological supplies, as well as certain orthotic braces, under the Medicare program. To make matters worse, CMS accelerated the timeline and some of the changes go into effect as early as next year. The full statement may be reviewed at: https://itemcoalition.org/wp-content/uploads/2025/12/item-coalition-competitive-bidding-program-expansion-press-statement-final.pdf United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to express our strong support for S. 2329, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act, and thank you for sponsoring this important bill. As you know, this bipartisan and bicameral legislation would help Medicare beneficiaries who use orthoses and prostheses to be as functional and independent-as possible while limiting waste, fraud, and abuse in the Medicare orthotic and prosthetic benefit. We applaud your leadership in sponsoring this bill and hope to work with you and your colleagues in the relevant committees of jurisdiction and leadership to enact this bill into law as soon as practicable. Letter to Senate Sponsors: ITEM Coalition Letter of Support for S. 2329, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the House sponsors of H.R. 4475, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act, to express our strong support and thank you for sponsoring this important bill. As you know, this bipartisan and bicameral legislation would help Medicare beneficiaries who use orthoses and prostheses to be as functional and independent as possible while limiting waste, fraud, and abuse in the Medicare orthotic and prosthetic benefit. We applaud your leadership in sponsoring this bill and hope to work with you and your colleagues in the relevant committees of jurisdiction and leadership to enact this bill into law as soon as practicable. Letter to House Sponsors: ITEM Coalition Letter of Support for H.R. 4475, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition strongly supported the expansion of Medicare coverage of sterile intermittent catheter kits for individuals with a spinal cord injury (SCI) regardless of the level of injury and submitted comments to the Durable Medical Equipment Medicare Administrative Contractors that read in part, While we support the proposed changes to the Local Coverage Determination (LCD, specifically, DL33803), we respectfully urge the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) to go further in the final LCD or in future LCDs to consider evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of etiology, including congenital conditions. United Spinal provided comments to the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) who had proposed Local Coverage Determination (LCD) for urological supplies. The comments read in part, United Spinal has long sought the physical and mental relief your proposed LCD will provide to those living with a spinal cord injury (SCI) by not requiring an individual to acquire two urinary tract infections (UTIs) within a 12-month period. Therefore, we are most pleased to comment on the proposal and to suggest how it could be expanded to further lower Americans health risks and further lower Americas healthcare costs. United Spinals policy fellow verbally commented to the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) who had proposed Local Coverage Determination (LCD) for urological supplies. The comments, in part read: United Spinal has long objected to the truly barbaric requirement that if you have a spinal cord injury, an SCI, you must have two urinary tract infections within twelve months before closed system Intermittent catheters will be covered. So, on behalf of those with SCIs across America, thank you for your proposed Local Coverage Determination (LCD). We do ask please that in the final LCD you clarify that having a SCI equates to immunosuppression. That will save America and countless Americans a lot of time and money. Thank you also for considering and acting favorably on the clinical evidence about the immunosuppression of those of us with a SCI. But most respectfully, there is also more you must do. We urge you to please go further in the final LCD to consider clinical evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of cause, including congenital conditions.

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

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

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

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

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

United Spinal advocated against Medicaid cuts. United Spinal asked members of Congress to sign onto letters of support with their colleagues, as part of United Spinal's virtual advocacy day urging bipartisan congressional leadership on the respective appropriations subcommittee to support increased federal funding for Spinal Cord Injury Model Systems as well as at 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. Advocate to save DOD CDMRP Spinal Cord Injury Research Program (SCIRP). The Federal Budget Resolution that was passed on 3.14.25 cut 57% - approximately $850 million - out of the Congressionally Directed Medical Research Program (CDMRP). This is a Department of Defense program that funds biomedical research programs, including spinal cord injury. United Spinal, as a member of the Disability & Rehabilitation Research Coalition (DRRC), supported a letter the DRRC co-coordinators submitted to the Acting Director of the Office of Management and Budget about the deep concerns the members of the Coalition had with the OMB Memorandum Pausing Federal Financial Assistance (M-25-13). United Spinal, as a member of the Disability & Rehabilitation Research Coalition (DRRC), signed onto a letter to the Office of Management and Budget, U. S. Department of Health and Human Services and the National Institutes of Health about major concerns with cuts to NIH funding through indirect cost cap. The letter read in part, The Disability & Rehabilitation Research Coalition (DRRC) appreciates and supports maximizing the federal return on investment in medical research but has serious concerns about the recently published Supplemental Guidance from the National Institutes of Health (NIH) capping indirect costs for grantees at 15 percent. This unprecedented policy change will have significant and permanent negative consequences on biomedical research, particularly the science of medical rehabilitation, disability, and chronic illness. We strongly urge you to reconsider this announcement and work with our coalition and other research organizations to chart an alternative path forward. United Spinal joined the American Association of People with Disabilities, along with numerous disability, civil rights, aging, and mental health organizations, in submitting a letter expressing deep concerns about the plan to re-organize the Department of Health and Human Services. especially the plan to eliminate the Administration for CommunityLiving (ACL) and split its functions across three other agencies, as well as the consolidation of the Office for Civil Rights (OCR) and Substance Abuse and Mental Health Services Agency (SAMHSA). United Spinal, as a member of the Disability & Rehabilitation Research Coalition (DRRC), signed onto a letter to urge and meet with HHS Secretary Kennedy to reconsider plans to dismantle the Administration for Community Living (ACL), including the National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR), in order to meet with national disability, rehabilitation, and other stakeholder organizations to discuss the future of ACL, and seriously reconsider the reorganization of this essential government agency for older Americans and individuals with disabilities. As a member of the Disability & Rehabilitation Research Coalition (DRRC), United Spinal endorsed comments submitted to the Office of Management and Budget (OMB) about OMB Memorandum Pausing Federal Financial Assistance (M-25-13). United Spinal, as a member of the Disability & Rehabilitation Research Coalition (DRRC), wrote to commend the National Institutes of Health (NIH) and the Division of Program Coordination, Planning, and Strategic Initiatives (DPCPSI) for their work to improve disability research across NIH on behalf of the one in four Americans with disabilities. Supporting disability research and investing in training the next generation of disability researchers must be a central goal at NIH given the critical need for biomedical, functional, and outcomes research. United Spinal, as members of the Disability and Aging Collaborative (DAC), the Health and Long-Term Services and Supports Task Forces of the Consortium for Constituents with Disabilities (CCD), and allied organizations wrote to the bipartisan leadership of the House Energy and Commerce Committee to urge excluding Medicaid cuts, work requirements, or any changes that limit funding or eligibility, from budget reconciliation or other legislation. The letter read in part, People with disabilities, older adults, family caregivers and their children, direct care workers, and other low-income individuals and families depend on Medicaid every day for their health, safety, and independence. Medicaid enables them to go to work and to care for their loved ones. It is our communities' lifeline, and we cannot afford for any part of it to be cut. United Spinal advocacy and policy staff met with staff for Sen. Tammy Duckworth (D-IL) to discuss legislation to address wheelchair repair issues, as well as an appropriations letter for the National Institute on Disability, Independent Living, and Rehabilitation Research. United Spinal advocacy and policy staff met with House and Senate to discuss signing an appropriations letter in support of the National Institute on Disability, Independent Living, and Rehabilitation Research. United Spinal advocacy and policy staff signed a CCD co-chairs statement expressing dismay and concern about the reorganization of the Department of Health and Human Services. United Spinal supports H.R. 2320, the Mobility Means Freedom Tax Credit Act.

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/text?s=3&r=1 United Spinal, along with numerous other disability organizations as members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force and fellow advocates in a letter urged the bipartisan leadership of the bicameral committees with jurisdiction in vehicle safety to consider and prioritize the safety and access needs of disabled passengers and pedestrians in any stand-alone autonomous vehicle (AV) legislation or surface transportation provisions. Recommendations in this letter reference Congressman Lattas 2023 SELF DRIVE Act discussion draft (SELF DRIVE Act Draft) and Congresswoman Dingells AV framework proposal (AV Framework Proposal). We recognize Representative Dingell and Lattas leadership of the Congressional Autonomous Vehicle Caucus and are grateful for their acknowledgement that disability rights advocates must be at the table as AV frameworks are developed. We are also providing Disability Access in AVs and Motor Vehicles draft bill text (Access in AVs Draft) for your consideration. The letter may be reviewed at: https://www.c-c-d.org/fichiers/Disability-AV-Leg-Priorities-Hill-Letter-122325.pdf United Spinal policy staff participated in the National Highway Traffic Safety Administrations (NHTSAs) Safety Research Portfolio Public Meeting in Washington, D. C. in November. Discussed the research opportunities for the United Spinal Associations SecureRide Coalitions automated wheelchair securement system. Policy staff followed up with NHTSA and Department of Transportation officials after the meetings. United Spinal policy staff provided feedback to members of Congress on potential legislation that would improve access to parking lots, especially for wheelchair users through data collection and an accessible parking standards analysis by the Government Accountability Office. United Spinal staff discussed potential legislative options to provide federal research with congressional staff to further develop automated securement for wheelchairs in motor vehicles. This would significantly improve the safety and independence of wheelchair users. United Spinal policy staff discussed highlighting United Spinals SecureRide automated wheelchair securement system initiative with National Council on Disability (NCD) staff to advance safer more independent wheelchair securement across all modes of transportation at a forthcoming autonomous vehicle industry meeting. United Spinals SecureRide initiative was highlighted in the NCDs recent report on ground transportation as a potential accessibility solution for automated vehicles. Currently most wheelchair users must rely on additional human assistance to secure their wheelchairs. The Report can be accessed here: https://www.ncd.gov/report/ground-transportation-for-people-with-mobility-disabilities-2025-challenges-and-progress/. United Spinal submitted comments in response to the Department of Transportations Request for Information: Research Ideas to Support Nationwide Automated Vehicle Deployment (DOT-OST-2025-1029-0038). The letter addressed safe wheelchair securement in motor vehicles and infrastructure needs. The letter read in part, For the nations 5.5 million wheelchair users, autonomous vehicles will be a game-changer, not only in meeting daily transportation needs but in vastly improving quality of lives. That includes fulfilling employment or education needs, healthcare and fitness needs but also civic and recreational opportunities. It will enrich families and social activities. The comments may be reviewed at: https://downloads.regulations.gov/DOT-OST-2025-1029-0038/attachment_1.pdf United Spinal supported comments submitted by the the Autonomous Vehicle Industry Association (AVIA) in response to the U.S.Department of Transportations (USDOT) Office of the Assistant Secretary for Research and Technologys (OST-R) Request for Information (RFI) on Research Ideas To Support Nationwide Automated Vehicle (AV) Deployment. As the leading organization focused on the development and deployment of autonomous vehicles (AVs), AVIA appreciates the USDOTs interest in coordinating research to support the nationwide deployment of automated driving system- (ADS) equipped transportation technology. AVs are a key emerging transportation technology, and the United States continues to lead the world on AV advancement. Further research and development of AV technologies-while simultaneously accelerating safe AV deployment across the country-can help ensure the United States maintains this leadership in the years and decades to come. The comments may be reviewed at: https://downloads.regulations.gov/DOT-OST-2025-1029-0026/attachment_1.pdf United Spinal supported comments submitted by the co-chairs of the Consortium for Constituents with Disabilities (CCD) Transportation on the proposed questions regarding research ideas to support nationwide automated vehicle deployment in response to the request for information (DOT-OST-2025-1029).The comments read part, further research is especially needed on developing independent, automated wheelchair and mobility device securement and activation of ramps or lifts. One area of research entails expanding the use of universal docking systems, such as a deployable anchor that automatically attaches to a users wheelchair or mobility device. Such restraint and securement standards could be expanded to personal vehicles for wheelchair users who drive, as well as to paratransit and rideshare service vans. This research ultimately could influence the development of independent securement standards across a wide range of transportation modes, including rail, air travel, or shuttles, in which people who use mobility devices currently have less access and safety than people without disabilities. The comments may be reviewed at: https://downloads.regulations.gov/DOT-OST-2025-1029-0037/attachment_1.pdf United Spinal supported comments submitted by the Disability Rights Education and Defense Fund (DREDF) which submitted comments in response to the Office of the Assistant Secretary for Research and Technologys request for information regarding research ideas to support nationwide automated vehicle (AV) deployment. United Spinals SecureRide Coalitions automated wheelchair securement system research needs are reflected in DREDFs AV research priorities. The comments may be reviewed at: https://downloads.regulations.gov/DOT-OST-2025-1029-0044/attachment_1.pdf United Spinal policy staff connected with a Department of Transportation official about our SecureRide Coalitions interest in providing the Department an informational update on the Coalitions automated wheelchair securement system initiative.

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

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

United Spinal, as a member of the Health and Long-Term Services and Supports Task force of the Consortium for Constituents with Disabilities (CCD), the Disability and Aging Collaborative (DAC), and allied organizations wrote to the Administrator of the Centers for Medicare and Medicaid Services to provide feedback on implementation of the new community engagement requirements enacted by the budget reconciliation act of 2025 (H.R. 1). The comments read in part, Congress intended to exempt people with disabilities and their caregivers from the community engagement requirements. With that in mind, we urge the Administration to use guidance and rulemaking to provide maximum protection for people with disabilities, older adults, and caregivers from coverage loss or disruption. The letter may be reviewed at: https://www.c-c-d.org/fichiers/Letter-from-Aging-and-Disability-Organizations-on-Medicaid-Community-Engagement-Requirements.pdf United Spinal supported and urged members of Congress to sign on to a letter to Dr. Mehmet Oz, Administrator, Centers for Medicare & Medicaid Services with concerns about expanding the agencys Competive Bidding Program. The letter read in part, As Members of Congress committed to advancing President Trumps America First agenda, we write to express serious concern that the Centers for Medicare and Medicaid Services proposed rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program may conflict with thePresidents directives on deregulation, trade, and domestic industrial strength. We respectfully urge CMS to pause and re-evaluate these provisions to ensure that they fully align with the Administrations goal of rebuilding American manufacturing, protecting Main Street businesses, and fostering innovation. United Spinal supported and advocated for members of Congress to sign onto a letter submitted țo the Administrator of the Centers for Medicare and Medicaid Services and the Director of the Office of Management and Budget. The letter read in part, We write to express our concerns regarding the Centers for Medicare & Medicaid Services (CMS) proposed Calendar Year (CY) Home Health proposed rules inclusion of ostomy, urological, and tracheostomy supplies in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. We respectfully request that the proposal for inclusion of these products be withdrawn as we believe it would 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. United Spinal, along with numerous other disability organizations and as members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the bipartisan leadership of the House Ways and Means and Energy and Commerce Committees as well as the Senate Finance Committee to encourage the leadership of the Senate and House committees of jurisdiction over the Medicare program to continue working with the Centers for Medicare and Medicaid Services (CMS) to enable Medicare beneficiaries living with disabilities and chronic obesity to access anti-obesity medications (AOMs) through the Medicare Part D program. The ITEM Coalition firmly believes that Medicare beneficiaries living with obesity, especially individuals with mobility impairments, should have equal access to the full continuum of obesity treatment options available to those living with chronic diseases such as diabetes and cardiovascular conditions, conditions where AOMs are already covered. The House letter may be reviewed at: https://itemcoalition.org/wp-content/uploads/2025/11/item-letter-to-congressional-committee-leadership-on-anti-obesity-medications-final.pdf United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition (https://itemcoalition.org/), supported a Coalitions press statement that expressed deep disappointment with a final rule that exposes Medicare patients to the lowest bidder for ostomy and urological supplies, as well as certain orthotic braces, under the Medicare program. To make matters worse, CMS accelerated the timeline and some of the changes go into effect as early as next year. The full statement may be reviewed at: https://itemcoalition.org/wp-content/uploads/2025/12/item-coalition-competitive-bidding-program-expansion-press-statement-final.pdf United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to express our strong support for S. 2329, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act, and thank you for sponsoring this important bill. As you know, this bipartisan and bicameral legislation would help Medicare beneficiaries who use orthoses and prostheses to be as functional and independent-as possible while limiting waste, fraud, and abuse in the Medicare orthotic and prosthetic benefit. We applaud your leadership in sponsoring this bill and hope to work with you and your colleagues in the relevant committees of jurisdiction and leadership to enact this bill into law as soon as practicable. Letter to Senate Sponsors: ITEM Coalition Letter of Support for S. 2329, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the House sponsors of H.R. 4475, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act, to express our strong support and thank you for sponsoring this important bill. As you know, this bipartisan and bicameral legislation would help Medicare beneficiaries who use orthoses and prostheses to be as functional and independent as possible while limiting waste, fraud, and abuse in the Medicare orthotic and prosthetic benefit. We applaud your leadership in sponsoring this bill and hope to work with you and your colleagues in the relevant committees of jurisdiction and leadership to enact this bill into law as soon as practicable. Letter to House Sponsors: ITEM Coalition Letter of Support for H.R. 4475, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition strongly supported the expansion of Medicare coverage of sterile intermittent catheter kits for individuals with a spinal cord injury (SCI) regardless of the level of injury and submitted comments to the Durable Medical Equipment Medicare Administrative Contractors that read in part, While we support the proposed changes to the Local Coverage Determination (LCD, specifically, DL33803), we respectfully urge the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) to go further in the final LCD or in future LCDs to consider evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of etiology, including congenital conditions. United Spinal provided comments to the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) who had proposed Local Coverage Determination (LCD) for urological supplies. The comments read in part, United Spinal has long sought the physical and mental relief your proposed LCD will provide to those living with a spinal cord injury (SCI) by not requiring an individual to acquire two urinary tract infections (UTIs) within a 12-month period. Therefore, we are most pleased to comment on the proposal and to suggest how it could be expanded to further lower Americans health risks and further lower Americas healthcare costs. United Spinals policy fellow verbally commented to the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) who had proposed Local Coverage Determination (LCD) for urological supplies. The comments, in part read: United Spinal has long objected to the truly barbaric requirement that if you have a spinal cord injury, an SCI, you must have two urinary tract infections within twelve months before closed system Intermittent catheters will be covered. So, on behalf of those with SCIs across America, thank you for your proposed Local Coverage Determination (LCD). We do ask please that in the final LCD you clarify that having a SCI equates to immunosuppression. That will save America and countless Americans a lot of time and money. Thank you also for considering and acting favorably on the clinical evidence about the immunosuppression of those of us with a SCI. But most respectfully, there is also more you must do. We urge you to please go further in the final LCD to consider clinical evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of cause, including congenital conditions.

United Spinal supports H. R. 4771/ S. 2438, the Transformation to Competitive Integrated Employment Act, which phases out the payment of subminimum wages under Section 14(c) of the FLSA over a five-year period. This legislation provides States, service providers, subminimum wage certificate holders, and other agencies with the resources they need to create competitive integrated employment service delivery models and the inclusive wraparound services that some e disabilities will need when subminimum wages are phased out. This legislation will align the treatment of workers with disabilities with existing federal policies.

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

United Spinal, as a member of the Health and Long-Term Services and Supports Task force of the Consortium for Constituents with Disabilities (CCD), the Disability and Aging Collaborative (DAC), and allied organizations wrote to the Administrator of the Centers for Medicare and Medicaid Services to provide feedback on implementation of the new community engagement requirements enacted by the budget reconciliation act of 2025 (H.R. 1). The comments read in part, Congress intended to exempt people with disabilities and their caregivers from the community engagement requirements. With that in mind, we urge the Administration to use guidance and rulemaking to provide maximum protection for people with disabilities, older adults, and caregivers from coverage loss or disruption. The letter may be reviewed at: https://www.c-c-d.org/fichiers/Letter-from-Aging-and-Disability-Organizations-on-Medicaid-Community-Engagement-Requirements.pdf United Spinal supported and urged members of Congress to sign on to a letter to Dr. Mehmet Oz, Administrator, Centers for Medicare & Medicaid Services with concerns about expanding the agencys Competive Bidding Program. The letter read in part, As Members of Congress committed to advancing President Trumps America First agenda, we write to express serious concern that the Centers for Medicare and Medicaid Services proposed rule (CMS-1828-P) to expand and redesign the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program may conflict with thePresidents directives on deregulation, trade, and domestic industrial strength. We respectfully urge CMS to pause and re-evaluate these provisions to ensure that they fully align with the Administrations goal of rebuilding American manufacturing, protecting Main Street businesses, and fostering innovation. United Spinal supported and advocated for members of Congress to sign onto a letter submitted țo the Administrator of the Centers for Medicare and Medicaid Services and the Director of the Office of Management and Budget. The letter read in part, We write to express our concerns regarding the Centers for Medicare & Medicaid Services (CMS) proposed Calendar Year (CY) Home Health proposed rules inclusion of ostomy, urological, and tracheostomy supplies in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. We respectfully request that the proposal for inclusion of these products be withdrawn as we believe it would 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. United Spinal, along with numerous other disability organizations and as members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the bipartisan leadership of the House Ways and Means and Energy and Commerce Committees as well as the Senate Finance Committee to encourage the leadership of the Senate and House committees of jurisdiction over the Medicare program to continue working with the Centers for Medicare and Medicaid Services (CMS) to enable Medicare beneficiaries living with disabilities and chronic obesity to access anti-obesity medications (AOMs) through the Medicare Part D program. The ITEM Coalition firmly believes that Medicare beneficiaries living with obesity, especially individuals with mobility impairments, should have equal access to the full continuum of obesity treatment options available to those living with chronic diseases such as diabetes and cardiovascular conditions, conditions where AOMs are already covered. The House letter may be reviewed at: https://itemcoalition.org/wp-content/uploads/2025/11/item-letter-to-congressional-committee-leadership-on-anti-obesity-medications-final.pdf United Spinal, along with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition (https://itemcoalition.org/), supported a Coalitions press statement that expressed deep disappointment with a final rule that exposes Medicare patients to the lowest bidder for ostomy and urological supplies, as well as certain orthotic braces, under the Medicare program. To make matters worse, CMS accelerated the timeline and some of the changes go into effect as early as next year. The full statement may be reviewed at: https://itemcoalition.org/wp-content/uploads/2025/12/item-coalition-competitive-bidding-program-expansion-press-statement-final.pdf United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to express our strong support for S. 2329, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act, and thank you for sponsoring this important bill. As you know, this bipartisan and bicameral legislation would help Medicare beneficiaries who use orthoses and prostheses to be as functional and independent-as possible while limiting waste, fraud, and abuse in the Medicare orthotic and prosthetic benefit. We applaud your leadership in sponsoring this bill and hope to work with you and your colleagues in the relevant committees of jurisdiction and leadership to enact this bill into law as soon as practicable. Letter to Senate Sponsors: ITEM Coalition Letter of Support for S. 2329, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, wrote to the House sponsors of H.R. 4475, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act, to express our strong support and thank you for sponsoring this important bill. As you know, this bipartisan and bicameral legislation would help Medicare beneficiaries who use orthoses and prostheses to be as functional and independent as possible while limiting waste, fraud, and abuse in the Medicare orthotic and prosthetic benefit. We applaud your leadership in sponsoring this bill and hope to work with you and your colleagues in the relevant committees of jurisdiction and leadership to enact this bill into law as soon as practicable. Letter to House Sponsors: ITEM Coalition Letter of Support for H.R. 4475, the Medicare Orthotics and Prosthetics (O&P) Patient-Centered Care Act. United Spinal, as a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition strongly supported the expansion of Medicare coverage of sterile intermittent catheter kits for individuals with a spinal cord injury (SCI) regardless of the level of injury and submitted comments to the Durable Medical Equipment Medicare Administrative Contractors that read in part, While we support the proposed changes to the Local Coverage Determination (LCD, specifically, DL33803), we respectfully urge the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) to go further in the final LCD or in future LCDs to consider evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of etiology, including congenital conditions. United Spinal provided comments to the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) who had proposed Local Coverage Determination (LCD) for urological supplies. The comments read in part, United Spinal has long sought the physical and mental relief your proposed LCD will provide to those living with a spinal cord injury (SCI) by not requiring an individual to acquire two urinary tract infections (UTIs) within a 12-month period. Therefore, we are most pleased to comment on the proposal and to suggest how it could be expanded to further lower Americans health risks and further lower Americas healthcare costs. United Spinals policy fellow verbally commented to the DME MACs (Durable Medical Equipment Medicare Administrative Contractors) who had proposed Local Coverage Determination (LCD) for urological supplies. The comments, in part read: United Spinal has long objected to the truly barbaric requirement that if you have a spinal cord injury, an SCI, you must have two urinary tract infections within twelve months before closed system Intermittent catheters will be covered. So, on behalf of those with SCIs across America, thank you for your proposed Local Coverage Determination (LCD). We do ask please that in the final LCD you clarify that having a SCI equates to immunosuppression. That will save America and countless Americans a lot of time and money. Thank you also for considering and acting favorably on the clinical evidence about the immunosuppression of those of us with a SCI. But most respectfully, there is also more you must do. We urge you to please go further in the final LCD to consider clinical evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of cause, including congenital conditions.

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

United Spinal supports H. R. 4771/ S. 2438, the Transformation to Competitive Integrated Employment Act, which phases out the payment of subminimum wages under Section 14(c) of the FLSA over a five-year period. This legislation provides States, service providers, subminimum wage certificate holders, and other agencies with the resources they need to create competitive integrated employment service delivery models and the inclusive wraparound services that some e disabilities will need when subminimum wages are phased out. This legislation will align the treatment of workers with disabilities with existing federal policies.

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

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

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

United Spinal Association supports: H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023 United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations. United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

United Spinal Association supports: H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023 United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations. United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024. United Spinal co-led and participated in virtual events with a coalition of disability organizations and the Service Employees International Union, inviting members of Congress and their staffs to learn about the importance of urging the US Department of Transportation to finalize its rule to ensure the safety and dignity of wheelchair users in air travel.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act/ S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024. United Spinal co-led and participated in virtual events with a coalition of disability organizations and the Service Employees International Union, inviting members of Congress and their staffs to learn about the importance of urging the US Department of Transportation to finalize its rule to ensure the safety and dignity of wheelchair users in air travel.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024.

United Spinal Association supports: Better Care Better Jobs Act (H.R. 547/S. 100), the HCBS Access Act (H.R. 1493/S. 762), the HCBS Relief Act (H.R. 6296/S. 3118). United Spinal raised the need to introduce federal legislation to address wheelchair repair reform, and legislation or report language to improve spinal cord injury rehabilitation outcomes. Follow up contacts with members of Congress on United Spinals Virtual Advocacy Day included recommendations for our members to advocate for the following policy issues with their members of Congress: Increase funding for SCI Model Systems. United Spinal policy staff advocated for Senators and Representatives to sign onto respective Dear Colleague letters for funding supporting increased funding for the Model Systems program and the Model Systems Knowledge Translational Center (MSKTC), funded by the National Institute on Disability, Independent Living, Rehabilitation Research (NIDILRR) at the U.S. Department of Health and Human Services and housed under the Administration for Community Living (ACL) in the FY 2025 Labor, Health and Human Services, Education Appropriations. The letter was addressed to the bipartisan leadership of the Senate Labor HHS Education Subcommittee on Appropriations. The letter read in part: The Model Systems program provides the entirety of the rehabilitation process from emergency services at the time of an injury through a persons return to full participation in the community for people with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury. The Model Systems program has not seen an increase in funding since 2006. Advocate for support of a House Dear Colleague letter as well for increaed funding for Spinal Cord Injury Model Systems. Continued raising support for FY2025 report language to direct the Centers for Medicare and Medicaid Services (CMS) to add and/or in the community to CMS policy for mobility assistive equipment and add and/or in the community to Social Security Act 1861 (n) which states that durable medical equipment including wheelchairs be used in the patients home only and support Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users. As a member of the Disability and Rehabilitation Research Coalition, United Spinal, along with numerous other disability organizations, signed on to a letter of thanks to Anjali Forber-Pratt, Ph.D. director, National Institute on Disability, Independent Living, and Rehabilitation Research for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2024-2028 Long Range Plan. United Spinal helped draft a United Spinal letter of interest for an Administration for Community Living grant: Disability and Rehabilitation Research Projects (DRRP) Program: Enhancing the Accessibility of Air Travel. As a member of the Disability & Rehabilitation on Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services to provide comments in response to the request for information on Research Data Request and Access Policy Changes. As a member of the Consortium for Constituents with Disabilities Technology and Telecommunications Task Force, United Spinal, along with numerous other disability organizations sent a letter to the bipartisan leadership of the Senate and House Labor, Health and Human Services and Education Appropriations Committees in support for the inclusion of $42 million in the Fiscal Year (FY) 2025 Senate Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. United Spinal supports H.R 1691 - Ensuring Patient Access to Critical Breakthrough Products Act. Wrote letters with CMS and met with CMS to talk about the need for Medicare coverage of transanal irrigation. Wrote letter to CMS DME MACS regarding needed reform in ostomy supplies coverage under Medicare. Health equity issues - Met with CMS, NIH, ACL and the White House at the Danish Embassy discussing the challenges of health equity concerns in the medical supplies sector. As part of the Coalition to Preserve Rehabilitation, United Spinal signed onto the FY2025 in-patient rehab proposed rule and the RFI on Medicare Advantage data. As part of the ITEM Coalition, United Spinal also submitted a letter to CMS in support of standing systems (power wheelchairs) and another letter in support of coding reform for catheters. United Spinal also signed on to a letter to President Biden, with multiple care support groups, in support of the creation of an Office for Caregiver Health.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act/ S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024. United Spinal co-led and participated in virtual events with a coalition of disability organizations and the Service Employees International Union, inviting members of Congress and their staffs to learn about the importance of urging the US Department of Transportation to finalize its rule to ensure the safety and dignity of wheelchair users in air travel.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024. United Spinal co-led and participated in virtual events with a coalition of disability organizations and the Service Employees International Union, inviting members of Congress and their staffs to learn about the importance of urging the US Department of Transportation to finalize its rule to ensure the safety and dignity of wheelchair users in air travel.

United Spinal Association supports H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA), H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. United Spinal supports and participates in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) on-going efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal submitted comments to the Department of Transportations proposed rule, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144), along with other stakeholders. United Spinal, along with numerous other organizations, sent a letter to Transportation Secretary Pete Buttigieg requesting that the U.S. Department of Transportation close the deadline outlined in the notice of proposed rulemaking (NPRM) entitled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST 2022-0144 sooner rather than later. The comment period for the NPRM was extended just 30 days and closed on June 12, 2024.

United Spinal Association supports: H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023 United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations. United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

United Spinal Association supports: H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023 United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations. United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

United Spinal Association supports: Better Care Better Jobs Act (H.R. 547/S. 100), the HCBS Access Act (H.R. 1493/S. 762), the HCBS Relief Act (H.R. 6296/S. 3118). United Spinal raised the need to introduce federal legislation to address wheelchair repair reform, and legislation or report language to improve spinal cord injury rehabilitation outcomes. Follow up contacts with members of Congress on United Spinals Virtual Advocacy Day included recommendations for our members to advocate for the following policy issues with their members of Congress: Increase funding for SCI Model Systems. United Spinal policy staff advocated for Senators and Representatives to sign onto respective Dear Colleague letters for funding supporting increased funding for the Model Systems program and the Model Systems Knowledge Translational Center (MSKTC), funded by the National Institute on Disability, Independent Living, Rehabilitation Research (NIDILRR) at the U.S. Department of Health and Human Services and housed under the Administration for Community Living (ACL) in the FY 2025 Labor, Health and Human Services, Education Appropriations. The letter was addressed to the bipartisan leadership of the Senate Labor HHS Education Subcommittee on Appropriations. The letter read in part: The Model Systems program provides the entirety of the rehabilitation process from emergency services at the time of an injury through a persons return to full participation in the community for people with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury. The Model Systems program has not seen an increase in funding since 2006. Advocate for support of a House Dear Colleague letter as well for increaed funding for Spinal Cord Injury Model Systems. Continued raising support for FY2025 report language to direct the Centers for Medicare and Medicaid Services (CMS) to add and/or in the community to CMS policy for mobility assistive equipment and add and/or in the community to Social Security Act 1861 (n) which states that durable medical equipment including wheelchairs be used in the patients home only and support Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users. As a member of the Disability and Rehabilitation Research Coalition, United Spinal, along with numerous other disability organizations, signed on to a letter of thanks to Anjali Forber-Pratt, Ph.D. director, National Institute on Disability, Independent Living, and Rehabilitation Research for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2024-2028 Long Range Plan. United Spinal helped draft a United Spinal letter of interest for an Administration for Community Living grant: Disability and Rehabilitation Research Projects (DRRP) Program: Enhancing the Accessibility of Air Travel. As a member of the Disability & Rehabilitation on Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services to provide comments in response to the request for information on Research Data Request and Access Policy Changes. As a member of the Consortium for Constituents with Disabilities Technology and Telecommunications Task Force, United Spinal, along with numerous other disability organizations sent a letter to the bipartisan leadership of the Senate and House Labor, Health and Human Services and Education Appropriations Committees in support for the inclusion of $42 million in the Fiscal Year (FY) 2025 Senate Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. United Spinal supports H.R 1691 - Ensuring Patient Access to Critical Breakthrough Products Act. Wrote letters with CMS and met with CMS to talk about the need for Medicare coverage of transanal irrigation. Wrote letter to CMS DME MACS regarding needed reform in ostomy supplies coverage under Medicare. Health equity issues - Met with CMS, NIH, ACL and the White House at the Danish Embassy discussing the challenges of health equity concerns in the medical supplies sector. As part of the Coalition to Preserve Rehabilitation, United Spinal signed onto the FY2025 in-patient rehab proposed rule and the RFI on Medicare Advantage data. As part of the ITEM Coalition, United Spinal also submitted a letter to CMS in support of standing systems (power wheelchairs) and another letter in support of coding reform for catheters. United Spinal also signed on to a letter to President Biden, with multiple care support groups, in support of the creation of an Office for Caregiver Health.

United Spinal Association supports: H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023 United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations. United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal Association supports: H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023 United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act. As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations. United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act/ S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal met with staff for the Senate Aging Committee to discuss next steps to increase funding for the National Institute on Disability, Independent Living, and Rehabilitation Research. United Spinal seeks legislative or report language directing the National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) and the National Institute of Neurological Disorders and Stroke (NINDS) to collaboratively conduct a pilot program measuring the potential beneficial health and functional short- and long-term outcomes and health cost savings achieved from extended lengths of stay in initial traumatic spinal cord injury (SCI) rehabilitation settings by employing needed technologies and enhancing consumer training. United Spinal Association supports "Connect For Health Act" which protects and extends Medicare reimbursement for telehealth. United Spinal supports legislation to improve wheelchair service repair and reform. United Spinal supports Medicare coverage for transanal irrigation for bowel management for individuals with neurogenic bowel. United Spinal supports Choices for Increased Mobility Act, H.R. 5371/S.5154 that will allow Medicare beneficiaries to obtain access to titanium and carbon fiber wheelchair frames. Congress must act to reinstate beneficiaries ability to upgrade to titanium and carbon fiber wheelchairs, at their own cost, if they so wish. Spoke with Senator Marco Rubio (R-FL) on the continuation of recognizing September's Spinal Cord Injury Awareness Month along with Sen. Tammy Baldwin (D-WI, now that Sen. Rubio has been nominated as Secretary of State. As a member of the Disability & Rehabilitation Research Coalition, United Spinal signed onto comments in response to the Request for Information (RFI): Eunice Kennedy Shriver National Institute of Child Health and Human Developments (NICHD) Strategic Plan for 2025-2029 (NOT-HD-24-028). Following the September implantable brain computer interface collaborative workshop at the U.S. Food and Drug Administration, United Spinal participated in workshop meetings with FDA staff and other stakeholders through the Fall. United Spinal Association endorsed a Coalition to Preserve Rehabilitation/Habilitation Benefits Coalition letter to the Center for Consumer Information and Insurance Oversight (CCIIO) at CMS about possible solutions to therapy caps.

United Spinal met with staff for the Senate Aging Committee to discuss next steps to increase funding for the National Institute on Disability, Independent Living, and Rehabilitation Research. United Spinal seeks legislative or report language directing the National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) and the National Institute of Neurological Disorders and Stroke (NINDS) to collaboratively conduct a pilot program measuring the potential beneficial health and functional short- and long-term outcomes and health cost savings achieved from extended lengths of stay in initial traumatic spinal cord injury (SCI) rehabilitation settings by employing needed technologies and enhancing consumer training. United Spinal Association supports "Connect For Health Act" which protects and extends Medicare reimbursement for telehealth. United Spinal supports legislation to improve wheelchair service repair and reform. United Spinal supports Medicare coverage for transanal irrigation for bowel management for individuals with neurogenic bowel. United Spinal supports Choices for Increased Mobility Act, H.R. 5371/S.5154 that will allow Medicare beneficiaries to obtain access to titanium and carbon fiber wheelchair frames. Congress must act to reinstate beneficiaries ability to upgrade to titanium and carbon fiber wheelchairs, at their own cost, if they so wish. Spoke with Senator Marco Rubio (R-FL) on the continuation of recognizing September's Spinal Cord Injury Awareness Month along with Sen. Tammy Baldwin (D-WI, now that Sen. Rubio has been nominated as Secretary of State. As a member of the Disability & Rehabilitation Research Coalition, United Spinal signed onto comments in response to the Request for Information (RFI): Eunice Kennedy Shriver National Institute of Child Health and Human Developments (NICHD) Strategic Plan for 2025-2029 (NOT-HD-24-028). Following the September implantable brain computer interface collaborative workshop at the U.S. Food and Drug Administration, United Spinal participated in workshop meetings with FDA staff and other stakeholders through the Fall. United Spinal Association endorsed a Coalition to Preserve Rehabilitation/Habilitation Benefits Coalition letter to the Center for Consumer Information and Insurance Oversight (CCIIO) at CMS about possible solutions to therapy caps.

United Spinal supports: H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act, introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH).

United Spinal supports H.R.7138, Supplemental Security Income Restoration Act of 2024, introduced by Raul M. Grijalva (D-AZ-7). The bill increases income disregard amounts that have not changed since 1974. Social Security Administration (SSA) currently reduces benefit amounts based on these out-of-date amounts and updates the asset limit to $10,000 / $20,000 for an eligible couple, so people are not excluded for responsibly saving money. United Spinal supports H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act, introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH). United Spinal signed on to a Consortium for Constituents with Disabilities Social Security Task Force transition memo to the Honorable Martin OMalley, Commissioner, Social Security Administration. The comments in part read, We use our collective expertise to offer recommendations on a wide range of legislative and administrative issues impacting people with disabilities.

United Spinal supports: H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act, introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH). In July, United Spinal supported a statement submitted by the cochairs of the Social Security Task Force of the Consortium for Citizens with Disabilities (CCD) of which we are a member, concerning a House hearing on June 18, 2024, entitled Work and Social Security Disability Benefits: Addressing Challenges and Creating Opportunities. The hearing was held on the important topic of barriers to workforce participation for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneficiaries. United Spinal, as a member of the Social Security Task Force (SSTF) of the Consortium for Constituents (CCD) with Disabilities, signed on to comments submitted to the Social Security Administrations (SSA) Commissioner, Martin OMalley in response to SSA Seeking to Simplify the Medical Record Collection Process. Concerns were expressed about the SSA-827 Proposal. The comments read in part, the SSA-827 form represents an important balance of protecting claimant privacy by requiring explicit authorization for the SSA to solicit the medical, education, and employment history necessary to adjudicate disability claims. Requested Members of Congress co-sponsor the Ensuring Access to Medicaid Buy-In Program Act.

United Spinal supports: H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act, introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH). In July, United Spinal supported a statement submitted by the cochairs of the Social Security Task Force of the Consortium for Citizens with Disabilities (CCD) of which we are a member, concerning a House hearing on June 18, 2024, entitled Work and Social Security Disability Benefits: Addressing Challenges and Creating Opportunities. The hearing was held on the important topic of barriers to workforce participation for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneficiaries. United Spinal, as a member of the Social Security Task Force (SSTF) of the Consortium for Constituents (CCD) with Disabilities, signed on to comments submitted to the Social Security Administrations (SSA) Commissioner, Martin OMalley in response to SSA Seeking to Simplify the Medical Record Collection Process. Concerns were expressed about the SSA-827 Proposal. The comments read in part, the SSA-827 form represents an important balance of protecting claimant privacy by requiring explicit authorization for the SSA to solicit the medical, education, and employment history necessary to adjudicate disability claims. Requested Members of Congress co-sponsor the Ensuring Access to Medicaid Buy-In Program Act.

United Spinal supports: H.R.7138 - Supplemental Security Income Restoration Act of 2024 H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act As a member of the Consortium for Constituents with Disabilities (CCD) Social Security Task Force, United Spinal, along with numerous other disability organizations, wrote to the bipartisan leadership of the House and Senate Subcommittees on Labor, Health and Human Services Appropriations to urge fully funding the Presidents budget request of $15.4 billion for SSAs FY 2025 administrative budget. United Spinal, as a member of the Social Security Task Force of the Consortium for Constituents with Disabilities supported a letter the Task Force Co-Chairs sent to The Honorable Martin OMalley, Commissioner, Social Security Administration in response to a NPRM on the Use of Electronic Payroll Data to Improve Program Administration [Docket No. SSA-2016-0039].

H.R. 5408 / S. 2767 - Introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH) SSI Savings Penalty Elimination Act. United Spinal, along with numerous other disability organizations, as members of the Consortium for Constituents with Disabilities (CCD), including CCDs Social Security Task Force (SSTF) and Housing Task Force (HTF), submitted comments to the Social Security Administrations Administrator in response to its Notice of Proposed Rulemaking: Docket No. SSA-2023-0010 Expansion of Rental Subsidy Policy for SSI. United Spinal, along with numerous other disability organizations, as members of the Social Security Task Force of the Consortium for Citizens with Disabilities (CCD) submitted comments about the proposed expansion of the definition of public assistance household in the Supplemental Security Income program (SSI), Docket No. SSA-2023-0015. United Spinal, along with numerous other disability organizations, as members of the Social Security Task Force of the Consortium for Citizens with Disabilities (CCD) submitted comments about the proposed Intermediate Improvement to the Disability Adjudication Process: Including How We Consider Past Work, Docket No. SSA-2023-0024.

United Spinal supports: H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act, introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH).

United Spinal Association supports: Better Care Better Jobs Act (H.R. 547/S. 100), the HCBS Access Act (H.R. 1493/S. 762), the HCBS Relief Act (H.R. 6296/S. 3118). United Spinal raised the need to introduce federal legislation to address wheelchair repair reform, and legislation or report language to improve spinal cord injury rehabilitation outcomes. Follow up contacts with members of Congress on United Spinals Virtual Advocacy Day included recommendations for our members to advocate for the following policy issues with their members of Congress: Increase funding for SCI Model Systems. United Spinal policy staff advocated for Senators and Representatives to sign onto respective Dear Colleague letters for funding supporting increased funding for the Model Systems program and the Model Systems Knowledge Translational Center (MSKTC), funded by the National Institute on Disability, Independent Living, Rehabilitation Research (NIDILRR) at the U.S. Department of Health and Human Services and housed under the Administration for Community Living (ACL) in the FY 2025 Labor, Health and Human Services, Education Appropriations. The letter was addressed to the bipartisan leadership of the Senate Labor HHS Education Subcommittee on Appropriations. The letter read in part: The Model Systems program provides the entirety of the rehabilitation process from emergency services at the time of an injury through a persons return to full participation in the community for people with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury. The Model Systems program has not seen an increase in funding since 2006. Advocate for support of a House Dear Colleague letter as well for increaed funding for Spinal Cord Injury Model Systems. Continued raising support for FY2025 report language to direct the Centers for Medicare and Medicaid Services (CMS) to add and/or in the community to CMS policy for mobility assistive equipment and add and/or in the community to Social Security Act 1861 (n) which states that durable medical equipment including wheelchairs be used in the patients home only and support Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users. As a member of the Disability and Rehabilitation Research Coalition, United Spinal, along with numerous other disability organizations, signed on to a letter of thanks to Anjali Forber-Pratt, Ph.D. director, National Institute on Disability, Independent Living, and Rehabilitation Research for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2024-2028 Long Range Plan. United Spinal helped draft a United Spinal letter of interest for an Administration for Community Living grant: Disability and Rehabilitation Research Projects (DRRP) Program: Enhancing the Accessibility of Air Travel. As a member of the Disability & Rehabilitation on Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services to provide comments in response to the request for information on Research Data Request and Access Policy Changes. As a member of the Consortium for Constituents with Disabilities Technology and Telecommunications Task Force, United Spinal, along with numerous other disability organizations sent a letter to the bipartisan leadership of the Senate and House Labor, Health and Human Services and Education Appropriations Committees in support for the inclusion of $42 million in the Fiscal Year (FY) 2025 Senate Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. United Spinal supports H.R 1691 - Ensuring Patient Access to Critical Breakthrough Products Act. Wrote letters with CMS and met with CMS to talk about the need for Medicare coverage of transanal irrigation. Wrote letter to CMS DME MACS regarding needed reform in ostomy supplies coverage under Medicare. Health equity issues - Met with CMS, NIH, ACL and the White House at the Danish Embassy discussing the challenges of health equity concerns in the medical supplies sector. As part of the Coalition to Preserve Rehabilitation, United Spinal signed onto the FY2025 in-patient rehab proposed rule and the RFI on Medicare Advantage data. As part of the ITEM Coalition, United Spinal also submitted a letter to CMS in support of standing systems (power wheelchairs) and another letter in support of coding reform for catheters. United Spinal also signed on to a letter to President Biden, with multiple care support groups, in support of the creation of an Office for Caregiver Health.

United Spinal Association supports: Better Care Better Jobs Act (H.R. 547/S. 100), the HCBS Access Act (H.R. 1493/S. 762), the HCBS Relief Act (H.R. 6296/S. 3118). United Spinal raised the need to introduce federal legislation to address wheelchair repair reform, and legislation or report language to improve spinal cord injury rehabilitation outcomes. Follow up contacts with members of Congress on United Spinals Virtual Advocacy Day included recommendations for our members to advocate for the following policy issues with their members of Congress: Increase funding for SCI Model Systems. United Spinal policy staff advocated for Senators and Representatives to sign onto respective Dear Colleague letters for funding supporting increased funding for the Model Systems program and the Model Systems Knowledge Translational Center (MSKTC), funded by the National Institute on Disability, Independent Living, Rehabilitation Research (NIDILRR) at the U.S. Department of Health and Human Services and housed under the Administration for Community Living (ACL) in the FY 2025 Labor, Health and Human Services, Education Appropriations. The letter was addressed to the bipartisan leadership of the Senate Labor HHS Education Subcommittee on Appropriations. The letter read in part: The Model Systems program provides the entirety of the rehabilitation process from emergency services at the time of an injury through a persons return to full participation in the community for people with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury. The Model Systems program has not seen an increase in funding since 2006. Advocate for support of a House Dear Colleague letter as well for increaed funding for Spinal Cord Injury Model Systems. Continued raising support for FY2025 report language to direct the Centers for Medicare and Medicaid Services (CMS) to add and/or in the community to CMS policy for mobility assistive equipment and add and/or in the community to Social Security Act 1861 (n) which states that durable medical equipment including wheelchairs be used in the patients home only and support Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users. As a member of the Disability and Rehabilitation Research Coalition, United Spinal, along with numerous other disability organizations, signed on to a letter of thanks to Anjali Forber-Pratt, Ph.D. director, National Institute on Disability, Independent Living, and Rehabilitation Research for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2024-2028 Long Range Plan. United Spinal helped draft a United Spinal letter of interest for an Administration for Community Living grant: Disability and Rehabilitation Research Projects (DRRP) Program: Enhancing the Accessibility of Air Travel. As a member of the Disability & Rehabilitation on Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services to provide comments in response to the request for information on Research Data Request and Access Policy Changes. As a member of the Consortium for Constituents with Disabilities Technology and Telecommunications Task Force, United Spinal, along with numerous other disability organizations sent a letter to the bipartisan leadership of the Senate and House Labor, Health and Human Services and Education Appropriations Committees in support for the inclusion of $42 million in the Fiscal Year (FY) 2025 Senate Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. United Spinal supports H.R 1691 - Ensuring Patient Access to Critical Breakthrough Products Act. Wrote letters with CMS and met with CMS to talk about the need for Medicare coverage of transanal irrigation. Wrote letter to CMS DME MACS regarding needed reform in ostomy supplies coverage under Medicare. Health equity issues - Met with CMS, NIH, ACL and the White House at the Danish Embassy discussing the challenges of health equity concerns in the medical supplies sector. As part of the Coalition to Preserve Rehabilitation, United Spinal signed onto the FY2025 in-patient rehab proposed rule and the RFI on Medicare Advantage data. As part of the ITEM Coalition, United Spinal also submitted a letter to CMS in support of standing systems (power wheelchairs) and another letter in support of coding reform for catheters. United Spinal also signed on to a letter to President Biden, with multiple care support groups, in support of the creation of an Office for Caregiver Health.

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act. The bill would provide $7 billion to fund the ACP through FY24. Engaged with the Federal Communications Commission to urge the strengthening of virtual access for the disability community.

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act. The bill would provide $7 billion to fund the ACP through FY24. United Spinal provided a letter of support for the Association of Assistive Technology Act Programs' (ATAP) proposal to the U.S. Department of Commerce, National Telecommunications and Information Administration for the Digital Equity Competitive Grant Program.

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act United Spinal, along with 270 other disability, civil rights, consumer protection, education, environmental and faith groups as well as municipal broadband departments, local, state and Tribal governments organizations, signed onto a letter to members of the U. S. House of Representatives requesting they sign H. Res. 1119, the discharge petition filed by Representative Clarke in support of H.R. 6929, the Affordable Connectivity Program Extension Act of 2024.

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act. The bill would provide $7 billion to fund the ACP through FY24. United Spinal provided a letter of support for the Association of Assistive Technology Act Programs' (ATAP) proposal to the U.S. Department of Commerce, National Telecommunications and Information Administration for the Digital Equity Competitive Grant Program.

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act. The bill would provide $7 billion to fund the ACP through FY24. Engaged with the Federal Communications Commission to urge the strengthening of virtual access for the disability community.

United Spinal responded to the Federal Communications Commissions The Reinstatement of Net Neutrality Rules (Docket No. 23-320) with comments. Which reads in part, Unfortunately, for the millions of people whom United Spinal represents, in too short a timeframe, the FCC has opined and acted on the need for dramatically more and dramatically less regulation with diametrically opposed voices. United Spinal supports H.R. 6929, The Affordable Connectivity Program Extension Act, introduced by Representative Yvette D. Clarke (D-NY-9). The bill would provide $7 billion to fund the ACP through FY24.

United Spinal responded to the Federal Communications Commissions The Reinstatement of Net Neutrality Rules (Docket No. 23-320) with comments. Which reads in part, Unfortunately, for the millions of people whom United Spinal represents, in too short a timeframe, the FCC has opined and acted on the need for dramatically more and dramatically less regulation with diametrically opposed voices. United Spinal supports H.R. 6929, The Affordable Connectivity Program Extension Act, introduced by Representative Yvette D. Clarke (D-NY-9). The bill would provide $7 billion to fund the ACP through FY24.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act/ S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal staff participated in a quarterly call with Amtrak along with other representatives from disability organizations. United Spinal staff participated in a meeting with Amtrak to review their plans for their replacement long-distance trainsets. United Spinal staff met with DOT staff to provide information about the results of United Spinals data gathering efforts regarding the availability of accessible parking spaces in different states and urging DOT to support updating the current ADA minimum standards for the number of accessible parking spaces required in lots and garages. House Senate United Spinal supported the accessibility provisions in, H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). https://www.congress.gov/bill/118th-congress/house-bill/7126/all-info?s=1&r=3 Department of Labor Department of Transportation United Spinal contributed comments and responded to comments of others in an IdeaScale: Dialogue about Exploring the Future of Public Transportation Research: A National Online Dialogue Comments in part included topic about research keeping pace with the continuing development of technologies that could improve accessibility for people with disabilities. Department of Transportation United Spinal supported the Department of Transportations future initiative to address the substantive issues involved with the service animal rule. The comments read in part, We request that as soon as possible you also convene meetings and conduct outreach throughout the disability community ,including wheelchair users, to address issues specific to the usefulness of the form, its role in the equitable air travel rights and responsibilities of passengers with disabilities as well as evaluating how well the current regulatory environment assist individuals using service animals in air travel. Department of Transportation United Spinal, along with numerous other disability organizations, as members of the Consortium for Constituents with Disabilities (CCD) Transportation Task Force signed on to comments on the Department of Transportations request for information (RFI) on accessibility improvements for transportation facilities, Docket No: DOT-OST-2023-0166. United Spinal submitted our own comments to the U. S. Department of Transportations (DOT) request for information on accessibility improvements for transportation facilities, Docket No: DOT-OST-2023-0166. The comments read in part: United Spinal contributed to and wholeheartedly supports the comments submitted by the Consortium for Constituents with Disabilities (CCD) in response to this RFI. We wish to further comment on some topics specifically from the perspective of the wheelchair user. Department of Transportation United Spinal, as a member of the SecureRide Coalition, helped draft and signed a letter to Tool, Inc., a company that has submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment. The letter read in part: The SecureRide Coalition strongly supports Tool, Inc.s application for the U. S. Department of Transportations (DOT) Phase I Small Business Innovation Research (SBIR) 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment. Due to the obvious efficiencies that can be achieved by employing integrated research, design and development methodologies with the two essential components of a wheelchair securement system, SecureRide also fully supports Tool., Inc.s SBIR application, 24-NH6: Anchor Design for Universal Docking Interface Geometry. National Highway Traffic Safety Administration United Spinal, as a member of SecureRide, met with National Highway TrafficSafety Administration officials in the Human Factors/Engineering Integration Division to discuss coordination of development of safe wheelchair securement standards. United Spinal Association appreciated the opportunity to provide comments on the Department of Transportations (DOT) renewal of the Service Animal Behavior and Health Attestation Form and supported the Department of Transportations future initiative to address the substantive issues involved with the service animal rule. The comments read in part, We request that as soon as possible you also convene meetings and conduct outreach throughout the disability community, including wheelchair users, to address issues specific to the usefulness of the form, its role in the equitable air travel rights and responsibilities of passengers with disabilities as well as evaluating how well the current regulatory environment assist individuals using service animals in air travel.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal supports H.R.7138, Supplemental Security Income Restoration Act of 2024, introduced by Raul M. Grijalva (D-AZ-7). The bill increases income disregard amounts that have not changed since 1974. Social Security Administration (SSA) currently reduces benefit amounts based on these out-of-date amounts and updates the asset limit to $10,000 / $20,000 for an eligible couple, so people are not excluded for responsibly saving money. United Spinal supports H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act, introduced by Representative Brian Higgins (D- NY-26) and Senator Sherrod Brown (D-OH). United Spinal signed on to a Consortium for Constituents with Disabilities Social Security Task Force transition memo to the Honorable Martin OMalley, Commissioner, Social Security Administration. The comments in part read, We use our collective expertise to offer recommendations on a wide range of legislative and administrative issues impacting people with disabilities.

United Spinal supports: H.R.7138 - Supplemental Security Income Restoration Act of 2024 H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act As a member of the Consortium for Constituents with Disabilities (CCD) Social Security Task Force, United Spinal, along with numerous other disability organizations, wrote to the bipartisan leadership of the House and Senate Subcommittees on Labor, Health and Human Services Appropriations to urge fully funding the Presidents budget request of $15.4 billion for SSAs FY 2025 administrative budget. United Spinal, as a member of the Social Security Task Force of the Consortium for Constituents with Disabilities supported a letter the Task Force Co-Chairs sent to The Honorable Martin OMalley, Commissioner, Social Security Administration in response to a NPRM on the Use of Electronic Payroll Data to Improve Program Administration [Docket No. SSA-2016-0039].

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act United Spinal, along with 270 other disability, civil rights, consumer protection, education, environmental and faith groups as well as municipal broadband departments, local, state and Tribal governments organizations, signed onto a letter to members of the U. S. House of Representatives requesting they sign H. Res. 1119, the discharge petition filed by Representative Clarke in support of H.R. 6929, the Affordable Connectivity Program Extension Act of 2024.

United Spinal Association supports: Better Care Better Jobs Act (H.R. 547/S. 100), the HCBS Access Act (H.R. 1493/S. 762), the HCBS Relief Act (H.R. 6296/S. 3118). United Spinal raised the need to introduce federal legislation to address wheelchair repair reform, and legislation or report language to improve spinal cord injury rehabilitation outcomes. Follow up contacts with members of Congress on United Spinals Virtual Advocacy Day included recommendations for our members to advocate for the following policy issues with their members of Congress: Increase funding for SCI Model Systems. United Spinal policy staff advocated for Senators and Representatives to sign onto respective Dear Colleague letters for funding supporting increased funding for the Model Systems program and the Model Systems Knowledge Translational Center (MSKTC), funded by the National Institute on Disability, Independent Living, Rehabilitation Research (NIDILRR) at the U.S. Department of Health and Human Services and housed under the Administration for Community Living (ACL) in the FY 2025 Labor, Health and Human Services, Education Appropriations. The letter was addressed to the bipartisan leadership of the Senate Labor HHS Education Subcommittee on Appropriations. The letter read in part: The Model Systems program provides the entirety of the rehabilitation process from emergency services at the time of an injury through a persons return to full participation in the community for people with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury. The Model Systems program has not seen an increase in funding since 2006. Advocate for support of a House Dear Colleague letter as well for increaed funding for Spinal Cord Injury Model Systems. Continued raising support for FY2025 report language to direct the Centers for Medicare and Medicaid Services (CMS) to add and/or in the community to CMS policy for mobility assistive equipment and add and/or in the community to Social Security Act 1861 (n) which states that durable medical equipment including wheelchairs be used in the patients home only and support Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users. As a member of the Disability and Rehabilitation Research Coalition, United Spinal, along with numerous other disability organizations, signed on to a letter of thanks to Anjali Forber-Pratt, Ph.D. director, National Institute on Disability, Independent Living, and Rehabilitation Research for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2024-2028 Long Range Plan. United Spinal helped draft a United Spinal letter of interest for an Administration for Community Living grant: Disability and Rehabilitation Research Projects (DRRP) Program: Enhancing the Accessibility of Air Travel. As a member of the Disability & Rehabilitation on Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services to provide comments in response to the request for information on Research Data Request and Access Policy Changes. As a member of the Consortium for Constituents with Disabilities Technology and Telecommunications Task Force, United Spinal, along with numerous other disability organizations sent a letter to the bipartisan leadership of the Senate and House Labor, Health and Human Services and Education Appropriations Committees in support for the inclusion of $42 million in the Fiscal Year (FY) 2025 Senate Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. United Spinal supports H.R 1691 - Ensuring Patient Access to Critical Breakthrough Products Act. Wrote letters with CMS and met with CMS to talk about the need for Medicare coverage of transanal irrigation. Wrote letter to CMS DME MACS regarding needed reform in ostomy supplies coverage under Medicare. Health equity issues - Met with CMS, NIH, ACL and the White House at the Danish Embassy discussing the challenges of health equity concerns in the medical supplies sector. As part of the Coalition to Preserve Rehabilitation, United Spinal signed onto the FY2025 in-patient rehab proposed rule and the RFI on Medicare Advantage data. As part of the ITEM Coalition, United Spinal also submitted a letter to CMS in support of standing systems (power wheelchairs) and another letter in support of coding reform for catheters. United Spinal also signed on to a letter to President Biden, with multiple care support groups, in support of the creation of an Office for Caregiver Health.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act. S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

United Spinal supports: H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act/ S. 1939, FAA Reauthorization Act of 2023 H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights. United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS). United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144. United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT- OST-2022-0144). United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144). United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right. United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation. United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4). United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.