ROSS MEGLATHERY

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. HR 3975 Veterans Homebuyer Accessibility Act of 2015-this bill amends the Internal Revenue Code, with respect to the tax credit for first-time homebuyers, to: (1) allow a veteran of the Armed Forces a tax credit for 10% of the purchase price of a principal residence purchased prior to January 1, 2018; (2) allow an additional credit for the cost, not exceeding $8,000 in a taxable year, of installing special fixtures or movable facilities in a residence to accommodate a disability of the veteran; and (3) require a recapture of credit amounts if the veteran sells such residence within 36 months after purchasing it. S 2683-sent a letter to Senator Hirono to support this legislation which verifies that leave credited to such an employee is used for treating a service-connected disability, the employee shall certify to FAA Human Resource Management that the employee used that leave for purposes of being furnished treatment for that disability by a health care provider. Wrote a letter to Senator Durbin in support of an amendment to HR 2577 requiring the VA to flag colleges that are under investigation. Sent a letter to VA Health Services Research & Development in support of a VA study Improving Home Accessibility for Veterans with Disabilities.

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015. Wrote a letter to CDC advocating for a Traumatic Brain Injury (TBI) survey. United Spinal signed onto Senate Health Education Labor and Pensions comment letter, facilitated by the HEALTH IT Now Coalition, of which United Spinal is a member, supporting expanded use of telehealth for individuals living with stroke and for expanded prediabetes education. United Spinal is actively engaged in ensuring improved access to, and education of, all prescription drugs including biologic pharmaceuticals (organic compounds used to treat individuals with MS, SCI etc.) and has requested additional meetings with personnel from the U.S. Food and Drug Administration. United Spinal supports S.849 - Advancing Research for Neurological Diseases Act of 2015. This bill will mandate that the Centers for Disease Control and Prevention track the incidence and prevalence of neurological diseases. United Spinal supports S. 800/H.R. 1631 - Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act which better coordinates rehabilitation and disability research at the NIH. The Disability and Rehabilitation Research Coalition (DRRC), of which United Spinal is a member, offered comments in a letter to the Administration for Community Living, U.S. Department of Health and Human Services, on the proposed rule entitled, National Institute on Disability, Independent Living, and Rehabilitation Research. The proposed rule would implement the Workforce Innovation and Opportunity Act of 2014 which made significant changes to Title II (Research) of the Rehabilitation Act of 1973. It would also move NIDILRR from the Department of Education to the Department of Health and Human Services (Administration for Community Living). United Spinal submitted comments to the FDA Arthritis Advisory Committee meeting to raise concerns about a Remicade-luck drugs and the effects of ankylosing spondylitis.

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Supports S. 2425 - Patient Access and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and complex rehab technology and accessories under Medicare's competitive acquisition program. Discussed with CMS consumer access problems with Medicare's competitive bidding program. United Spinal submitted comments to the Centers for Medicare and Medicaid Services regarding Medicaid access to covered services. United Spinal signed onto a comment letter to entities in the Federally-Facilitated Marketplaces, seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Marketplaces (FFMs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance for the disability population. United Spinal opposes the provision in the FY2017 Presidential Budget to provide authority to expand competitive bidding for certain durable medical equipment specifically: ostomy and urological supplies. United Spinal commented to CMS on the issue of discharge planning for hospitals, critical access hospitals, and home health agencies. This proposed rule would revise the discharge planning requirements in order to participate in the Medicare and Medicaid programs. United Spinal signed onto a letter to CMS opposing the same reimbursement to Medicare from skilled nursing facilities as well as in-patient rehab facilities and units (IRFs). United Spinal also edited and endorsed a letter from Congressman G. T. Thompson (R-PA) to the Centers for Medicare and Medicaid Services to urge Medicare Advantage plants to follow Medicare criteria Medicare IRF coverage criteria when determining coverage for IRF care. United Spinal signed onto a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the Summary of Benefits and Coverage, the Uniform Glossary of Medical Terms. United Spinal signed onto a letter to MedPAC on Medicare Part D cost sharing for LIS and dual eligible beneficiaries. Generic Utilization is already high in both LIS and non-LIS populations and higher cost sharing for branded products could reduce adherence, increase spending on other health care services in Medicare/Medicaid.

HR 3229/S. 2196 To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Spoke with Rep. Jared Polis district staff member regarding casework for a United Spinal member. H.R. 1516/S. 1013 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. A proposal in the Presidents FY2017 Budget expands the competitive bidding program to additional categories, including ostomy and urological supplies. This decision will limit access to prosthetic supplies which need to be clinically prescribed, selected, and/or adjusted and fitted for individuals by specially trained health care professionals based on the unique medical and physical needs of each person in relation to their disease or condition. The incorrect catheters or ostomy supplies can put individuals at risk of severe skin damage, infection, hospitalization and possibly death. Since ostomy and urological medical supplies restore the lost functions of waste storage and elimination, they are defined in the Social Security Act as prosthetics. United Spinal signed onto a letter, led by the Center for Medicare Advocacy, to the Centers for Medicare and Medicaid Services highlighting the problems with access to durable medical equipment (such as wheelchairs and other assistive technology and medical equipment that can be used in the home) when individuals are dual-eligibles - that is, on Medicare and Medicaid. There continues to be a misalignment of payment procedures in Medicare and Medicaid resulting in denials, delays, and higher than appropriate health care costs for essential DME among dually eligible beneficiaries. United Spinal supports the recommended solution which requires state Medicaid agencies, as is the law in Connecticut, to process prior authorization requests for DME for Medicaid beneficiaries whether or not they also are on Medicare. United Spinal signed onto a letter to the House in support of H.R. 5721, the Local Coverage Determination Clarification Act. This important legislation would help ensure basic procedural fairness in Local Coverage Determinations (LCDs), and thereby provide an important Medicare beneficiary protection that is often lacking in local coverage decisions. Competitive Bidding Letter United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services (CMS) supporting competitive bidding reforms including the requirement of DME provider state licensure; the letter states its opposition to the competitive bidding programs limits on choice, access and quality of durable medical equipment. Negative Pressure Wound Therapy United Spinal signed onto this CMS letter which focused on the proposal to implement the newly created statutory benefit to pay home health agencies separately for disposable negative pressure wound therapy. In general, the letter supports the Centers for Medicare and Medicaid Services (CMS) proposal implementing the new statutory benefit to ensure patient access to this important therapy. United Spinal signed onto and helped draft a letter to the Centers for Medicare and Medicaid Services opposing charging people with mobility impairments an extra payment for physician time. PAC VBP United Spinal signed onto this written statement on the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298) regarding Medicare Spending per Beneficiary (MSPB) measure. MSPB is an economic measure to assess Medicare utilization and is used to ascertain the productivity of a provider within a given setting, or a type of provider compared to another type of provider. The letter states that the PAC-VBP program should not measure MSPB without simultaneously measuring quality, function, and quality of life outcomes so that the Medicare program knows what it is getting for its payments to providers. ICD-10 United Spinal Association, and other stakeholders, requested an in-person meeting to discuss the unintended consequences of ICD-10 conversion on access to inpatient rehabilitation hospitals and units (IRFs) for Medicare beneficiaries with brain injuries and select orthopedic conditions, and to explore possible remedies to this problem. MPFS 2017 and OPPS 2017 United Spinal signed onto a couple of letters to the Centers for Medicare and Medicaid Services on related to various health IT provisions ensuring better protections of chronic care management services and streamlining tools for advanced imaging services.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Conducted a Congressional Expo and Briefing on HR 1516/S. 1013 and H.R. 3229 and S. 2196 and educated Congress and the Government Accountability Office on the differences between manual and power CRT. United Spinal, as one of several consumer and disability stakeholders, raised concerns with the Administration for Community Living and the Centers for Medicare and Medicaid Services on access to durable medical equipment as urological and ostomy supplies with the expansion of competitive bidding under Medicare. United Spinal, in collaboration with United Spinals Urology Coalition, opposes expanding Medicares competitive bidding program to urology and ostomy supplies, as laid out in the Presidents Budget. United Spinal also sent a consumer and clinician letter to the committees of jurisdiction opposing the expansion. Part B Demonstration United Spinal signed onto two separate letters led by the Partnership to Improve Patient Care and the MS Coalition, to the Centers for Medicare and Medicaid Services opposing tying payment of drugs to cost-effectiveness. In early 2016, several bipartisan and nonpartisan organizations, including the Bipartisan Policy Center and the Long-Term Care Financing Collaborative, released reports on a path forward for future financing of our nations long-term care needs. The problem is clear: while our nation is aging and people are living longer with disabilities and chronic conditions, we lack a coherent plan on how to provide for their care and supports. Our current financing system relies almost entirely on Medicaid and unpaid family caregivers, both of which thwart family financial planning and hinder the economic opportunities of women, people of color, and people with disabilities. The Consortium for Citizens with Disabilities (CCD) Long-Term Services and Supports Task Force of CCD released a statement, which United Spinal endorsed, to weigh in on the recent reports on long-term care financing, express our support for Medicaid improvements, and support the emerging consensus on the need for a public insurance program. United Spinal signed onto an ITEM Coalition letter in support of HR 5210, the Protecting Patient Access to Durable Medical Equipment Act to Secretary Sylvia Burwell of the Department of Health and Human Services. This letter urged the Centers for Medicare and Medicaid Services (CMS) to extend the current six-month phase-in of modified payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for an additional 12 months to avoid disruption in care to beneficiaries. United Spinal is working on increasing coverage for powered exoskeleton devices and on a Congressional advocacy campaign to make Congress aware of research showing benefits to SCI individual in the use of these devices and to help powered exoskeleton devices gain and maintain regulatory approvals and additional insurance carrier recognition.

HR 3229/S. 2196 To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Spoke with Rep. Jared Polis district staff member regarding casework for a United Spinal member. H.R. 1516/S. 1013 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. A proposal in the Presidents FY2017 Budget expands the competitive bidding program to additional categories, including ostomy and urological supplies. This decision will limit access to prosthetic supplies which need to be clinically prescribed, selected, and/or adjusted and fitted for individuals by specially trained health care professionals based on the unique medical and physical needs of each person in relation to their disease or condition. The incorrect catheters or ostomy supplies can put individuals at risk of severe skin damage, infection, hospitalization and possibly death. Since ostomy and urological medical supplies restore the lost functions of waste storage and elimination, they are defined in the Social Security Act as prosthetics. United Spinal signed onto a letter, led by the Center for Medicare Advocacy, to the Centers for Medicare and Medicaid Services highlighting the problems with access to durable medical equipment (such as wheelchairs and other assistive technology and medical equipment that can be used in the home) when individuals are dual-eligibles - that is, on Medicare and Medicaid. There continues to be a misalignment of payment procedures in Medicare and Medicaid resulting in denials, delays, and higher than appropriate health care costs for essential DME among dually eligible beneficiaries. United Spinal supports the recommended solution which requires state Medicaid agencies, as is the law in Connecticut, to process prior authorization requests for DME for Medicaid beneficiaries whether or not they also are on Medicare. United Spinal signed onto a letter to the House in support of H.R. 5721, the Local Coverage Determination Clarification Act. This important legislation would help ensure basic procedural fairness in Local Coverage Determinations (LCDs), and thereby provide an important Medicare beneficiary protection that is often lacking in local coverage decisions. Competitive Bidding Letter United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services (CMS) supporting competitive bidding reforms including the requirement of DME provider state licensure; the letter states its opposition to the competitive bidding programs limits on choice, access and quality of durable medical equipment. Negative Pressure Wound Therapy United Spinal signed onto this CMS letter which focused on the proposal to implement the newly created statutory benefit to pay home health agencies separately for disposable negative pressure wound therapy. In general, the letter supports the Centers for Medicare and Medicaid Services (CMS) proposal implementing the new statutory benefit to ensure patient access to this important therapy. United Spinal signed onto and helped draft a letter to the Centers for Medicare and Medicaid Services opposing charging people with mobility impairments an extra payment for physician time. PAC VBP United Spinal signed onto this written statement on the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298) regarding Medicare Spending per Beneficiary (MSPB) measure. MSPB is an economic measure to assess Medicare utilization and is used to ascertain the productivity of a provider within a given setting, or a type of provider compared to another type of provider. The letter states that the PAC-VBP program should not measure MSPB without simultaneously measuring quality, function, and quality of life outcomes so that the Medicare program knows what it is getting for its payments to providers. ICD-10 United Spinal Association, and other stakeholders, requested an in-person meeting to discuss the unintended consequences of ICD-10 conversion on access to inpatient rehabilitation hospitals and units (IRFs) for Medicare beneficiaries with brain injuries and select orthopedic conditions, and to explore possible remedies to this problem. MPFS 2017 and OPPS 2017 United Spinal signed onto a couple of letters to the Centers for Medicare and Medicaid Services on related to various health IT provisions ensuring better protections of chronic care management services and streamlining tools for advanced imaging services.

HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. HR 3975 Veterans Homebuyer Accessibility Act of 2015-this bill amends the Internal Revenue Code, with respect to the tax credit for first-time homebuyers, to: (1) allow a veteran of the Armed Forces a tax credit for 10% of the purchase price of a principal residence purchased prior to January 1, 2018; (2) allow an additional credit for the cost, not exceeding $8,000 in a taxable year, of installing special fixtures or movable facilities in a residence to accommodate a disability of the veteran; and (3) require a recapture of credit amounts if the veteran sells such residence within 36 months after purchasing it. S 2683-sent a letter to Senator Hirono to support this legislation which verifies that leave credited to such an employee is used for treating a service-connected disability, the employee shall certify to FAA Human Resource Management that the employee used that leave for purposes of being furnished treatment for that disability by a health care provider. Wrote a letter to Senator Durbin in support of an amendment to HR 2577 requiring the VA to flag colleges that are under investigation. Sent a letter to VA Health Services Research & Development in support of a VA study Improving Home Accessibility for Veterans with Disabilities.

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. HR 3975 Veterans Homebuyer Accessibility Act of 2015-this bill amends the Internal Revenue Code, with respect to the tax credit for first-time homebuyers, to: (1) allow a veteran of the Armed Forces a tax credit for 10% of the purchase price of a principal residence purchased prior to January 1, 2018; (2) allow an additional credit for the cost, not exceeding $8,000 in a taxable year, of installing special fixtures or movable facilities in a residence to accommodate a disability of the veteran; and (3) require a recapture of credit amounts if the veteran sells such residence within 36 months after purchasing it. S 2683-sent a letter to Senator Hirono to support this legislation which verifies that leave credited to such an employee is used for treating a service-connected disability, the employee shall certify to FAA Human Resource Management that the employee used that leave for purposes of being furnished treatment for that disability by a health care provider. Wrote a letter to Senator Durbin in support of an amendment to HR 2577 requiring the VA to flag colleges that are under investigation. Sent a letter to VA Health Services Research & Development in support of a VA study Improving Home Accessibility for Veterans with Disabilities.

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

National Defense Authorization Act FY 2017, HR 4909 United Spinal signed onto a letter to the House and Senate Armed Services Committee regarding the FY 2017 National Defense Authorization Act (NDAA) opposing weakened provisions regarding the federal contractors that have violated Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA) - both of which address the recruiting and hiring of people with disabilities and veterans and other civil rights or labor laws when they bid on contracts. This provision is limited to contractors that have actually been debarred. This letter from the CCD Employment, Rights, and Veterans Task Forces urges the Armed Services committee leadership in both houses to remove the weakened provision. Doing so would hold federal contractors accountable for disability discrimination and discrimination against veterans (as well as violations of other laws). United Spinal, along with other disability advocacy stakeholders, engaged in dialogue with DOLs Office of Disability Employment Policy (ODEP) and the Office of Federal Contract Compliance Programs (OFCCP) to hear updates on contractor compliance and non-compliance regarding the 503 rule and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), that is, the hiring and recruitment of individuals with disabilities, including veterans, amongst federal contractors. United Spinal signed on to a letter to Congress on the Transition to Independence Act, HR 5903, introduced by Rep. Chris Van Hollen, (D-MD-8th) which will foster skills building and career advancement for thousands of people with disabilities as well as providing the necessary data to expand successful practices nationwide.

Signed on to a joint letter of support of the National Defense Authorization Act for FY 2017, HR 4909, provision advocating protecting victims of military sexual trauma from non-disability mental health discharges from the military that give them other than honorable discharges - House and Senate HR 5620 Sent a letter of support to amend title 38, United States Code, to provide for the removal or demotion of employees of the Department of Veterans Affairs based on performance or misconduct, and for other purposes - House HR 5128 & S 3141 Protection & Advocacy for Veterans Act. Sent a letter of support of this legislation - a VA grant to improve the monitoring of mental health & substance abuse treatment programs of the Department of Veterans Affairs. - House and Senate Sent a letter for the Congressional record to VA Transportation & Infrastructure subcommittee requesting that they fund VA leases for VA medical facilities - House and Senate National Defense Authorization Act FY 2017, HR 4909 United Spinal signed onto a letter to the House and Senate Armed Services Committee regarding the FY 2017 National Defense Authorization Act (NDAA) opposing weakened provisions regarding the federal contractors that have violated Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA) - both of which address the recruiting and hiring of people with disabilities and veterans and other civil rights or labor laws when they bid on contracts. This provision is limited to contractors that have actually been debarred. This letter from the CCD Employment, Rights, and Veterans Task Forces urges the Armed Services committee leadership in both houses to remove the weakened provision. Doing so would hold federal contractors accountable for disability discrimination and discrimination against veterans (as well as violations of other laws).

Signed on to a letter to House Armed Services Committee to oppose a Senator Joe Manchin amendment, part of the National Defense Authorization Act of FY 2017, HR 4909, which allows schools to solicit on military bases - House and Senate

Signed on to a joint letter of support of the National Defense Authorization Act for FY 2017, HR 4909, provision advocating protecting victims of military sexual trauma from non-disability mental health discharges from the military that give them other than honorable discharges - House and Senate HR 5620 Sent a letter of support to amend title 38, United States Code, to provide for the removal or demotion of employees of the Department of Veterans Affairs based on performance or misconduct, and for other purposes - House HR 5128 & S 3141 Protection & Advocacy for Veterans Act. Sent a letter of support of this legislation - a VA grant to improve the monitoring of mental health & substance abuse treatment programs of the Department of Veterans Affairs. - House and Senate Sent a letter for the Congressional record to VA Transportation & Infrastructure subcommittee requesting that they fund VA leases for VA medical facilities - House and Senate National Defense Authorization Act FY 2017, HR 4909 United Spinal signed onto a letter to the House and Senate Armed Services Committee regarding the FY 2017 National Defense Authorization Act (NDAA) opposing weakened provisions regarding the federal contractors that have violated Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA) - both of which address the recruiting and hiring of people with disabilities and veterans and other civil rights or labor laws when they bid on contracts. This provision is limited to contractors that have actually been debarred. This letter from the CCD Employment, Rights, and Veterans Task Forces urges the Armed Services committee leadership in both houses to remove the weakened provision. Doing so would hold federal contractors accountable for disability discrimination and discrimination against veterans (as well as violations of other laws).

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Conducted a Congressional Expo and Briefing on HR 1516/S. 1013 and H.R. 3229 and S. 2196 and educated Congress and the Government Accountability Office on the differences between manual and power CRT. United Spinal, as one of several consumer and disability stakeholders, raised concerns with the Administration for Community Living and the Centers for Medicare and Medicaid Services on access to durable medical equipment as urological and ostomy supplies with the expansion of competitive bidding under Medicare. United Spinal, in collaboration with United Spinals Urology Coalition, opposes expanding Medicares competitive bidding program to urology and ostomy supplies, as laid out in the Presidents Budget. United Spinal also sent a consumer and clinician letter to the committees of jurisdiction opposing the expansion. Part B Demonstration United Spinal signed onto two separate letters led by the Partnership to Improve Patient Care and the MS Coalition, to the Centers for Medicare and Medicaid Services opposing tying payment of drugs to cost-effectiveness. In early 2016, several bipartisan and nonpartisan organizations, including the Bipartisan Policy Center and the Long-Term Care Financing Collaborative, released reports on a path forward for future financing of our nations long-term care needs. The problem is clear: while our nation is aging and people are living longer with disabilities and chronic conditions, we lack a coherent plan on how to provide for their care and supports. Our current financing system relies almost entirely on Medicaid and unpaid family caregivers, both of which thwart family financial planning and hinder the economic opportunities of women, people of color, and people with disabilities. The Consortium for Citizens with Disabilities (CCD) Long-Term Services and Supports Task Force of CCD released a statement, which United Spinal endorsed, to weigh in on the recent reports on long-term care financing, express our support for Medicaid improvements, and support the emerging consensus on the need for a public insurance program. United Spinal signed onto an ITEM Coalition letter in support of HR 5210, the Protecting Patient Access to Durable Medical Equipment Act to Secretary Sylvia Burwell of the Department of Health and Human Services. This letter urged the Centers for Medicare and Medicaid Services (CMS) to extend the current six-month phase-in of modified payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for an additional 12 months to avoid disruption in care to beneficiaries. United Spinal is working on increasing coverage for powered exoskeleton devices and on a Congressional advocacy campaign to make Congress aware of research showing benefits to SCI individual in the use of these devices and to help powered exoskeleton devices gain and maintain regulatory approvals and additional insurance carrier recognition.

Signed on to a joint letter of support of the National Defense Authorization Act for FY 2017, HR 4909, provision advocating protecting victims of military sexual trauma from non-disability mental health discharges from the military that give them other than honorable discharges - House and Senate HR 5620 Sent a letter of support to amend title 38, United States Code, to provide for the removal or demotion of employees of the Department of Veterans Affairs based on performance or misconduct, and for other purposes - House HR 5128 & S 3141 Protection & Advocacy for Veterans Act. Sent a letter of support of this legislation - a VA grant to improve the monitoring of mental health & substance abuse treatment programs of the Department of Veterans Affairs. - House and Senate Sent a letter for the Congressional record to VA Transportation & Infrastructure subcommittee requesting that they fund VA leases for VA medical facilities - House and Senate National Defense Authorization Act FY 2017, HR 4909 United Spinal signed onto a letter to the House and Senate Armed Services Committee regarding the FY 2017 National Defense Authorization Act (NDAA) opposing weakened provisions regarding the federal contractors that have violated Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA) - both of which address the recruiting and hiring of people with disabilities and veterans and other civil rights or labor laws when they bid on contracts. This provision is limited to contractors that have actually been debarred. This letter from the CCD Employment, Rights, and Veterans Task Forces urges the Armed Services committee leadership in both houses to remove the weakened provision. Doing so would hold federal contractors accountable for disability discrimination and discrimination against veterans (as well as violations of other laws).

HR 3229/S. 2196 To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Spoke with Rep. Jared Polis district staff member regarding casework for a United Spinal member. H.R. 1516/S. 1013 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. A proposal in the Presidents FY2017 Budget expands the competitive bidding program to additional categories, including ostomy and urological supplies. This decision will limit access to prosthetic supplies which need to be clinically prescribed, selected, and/or adjusted and fitted for individuals by specially trained health care professionals based on the unique medical and physical needs of each person in relation to their disease or condition. The incorrect catheters or ostomy supplies can put individuals at risk of severe skin damage, infection, hospitalization and possibly death. Since ostomy and urological medical supplies restore the lost functions of waste storage and elimination, they are defined in the Social Security Act as prosthetics. United Spinal signed onto a letter, led by the Center for Medicare Advocacy, to the Centers for Medicare and Medicaid Services highlighting the problems with access to durable medical equipment (such as wheelchairs and other assistive technology and medical equipment that can be used in the home) when individuals are dual-eligibles - that is, on Medicare and Medicaid. There continues to be a misalignment of payment procedures in Medicare and Medicaid resulting in denials, delays, and higher than appropriate health care costs for essential DME among dually eligible beneficiaries. United Spinal supports the recommended solution which requires state Medicaid agencies, as is the law in Connecticut, to process prior authorization requests for DME for Medicaid beneficiaries whether or not they also are on Medicare. United Spinal signed onto a letter to the House in support of H.R. 5721, the Local Coverage Determination Clarification Act. This important legislation would help ensure basic procedural fairness in Local Coverage Determinations (LCDs), and thereby provide an important Medicare beneficiary protection that is often lacking in local coverage decisions. Competitive Bidding Letter United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services (CMS) supporting competitive bidding reforms including the requirement of DME provider state licensure; the letter states its opposition to the competitive bidding programs limits on choice, access and quality of durable medical equipment. Negative Pressure Wound Therapy United Spinal signed onto this CMS letter which focused on the proposal to implement the newly created statutory benefit to pay home health agencies separately for disposable negative pressure wound therapy. In general, the letter supports the Centers for Medicare and Medicaid Services (CMS) proposal implementing the new statutory benefit to ensure patient access to this important therapy. United Spinal signed onto and helped draft a letter to the Centers for Medicare and Medicaid Services opposing charging people with mobility impairments an extra payment for physician time. PAC VBP United Spinal signed onto this written statement on the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298) regarding Medicare Spending per Beneficiary (MSPB) measure. MSPB is an economic measure to assess Medicare utilization and is used to ascertain the productivity of a provider within a given setting, or a type of provider compared to another type of provider. The letter states that the PAC-VBP program should not measure MSPB without simultaneously measuring quality, function, and quality of life outcomes so that the Medicare program knows what it is getting for its payments to providers. ICD-10 United Spinal Association, and other stakeholders, requested an in-person meeting to discuss the unintended consequences of ICD-10 conversion on access to inpatient rehabilitation hospitals and units (IRFs) for Medicare beneficiaries with brain injuries and select orthopedic conditions, and to explore possible remedies to this problem. MPFS 2017 and OPPS 2017 United Spinal signed onto a couple of letters to the Centers for Medicare and Medicaid Services on related to various health IT provisions ensuring better protections of chronic care management services and streamlining tools for advanced imaging services.

National Defense Authorization Act FY 2017, HR 4909 United Spinal signed onto a letter to the House and Senate Armed Services Committee regarding the FY 2017 National Defense Authorization Act (NDAA) opposing weakened provisions regarding the federal contractors that have violated Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA) - both of which address the recruiting and hiring of people with disabilities and veterans and other civil rights or labor laws when they bid on contracts. This provision is limited to contractors that have actually been debarred. This letter from the CCD Employment, Rights, and Veterans Task Forces urges the Armed Services committee leadership in both houses to remove the weakened provision. Doing so would hold federal contractors accountable for disability discrimination and discrimination against veterans (as well as violations of other laws). United Spinal, along with other disability advocacy stakeholders, engaged in dialogue with DOLs Office of Disability Employment Policy (ODEP) and the Office of Federal Contract Compliance Programs (OFCCP) to hear updates on contractor compliance and non-compliance regarding the 503 rule and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), that is, the hiring and recruitment of individuals with disabilities, including veterans, amongst federal contractors. United Spinal signed on to a letter to Congress on the Transition to Independence Act, HR 5903, introduced by Rep. Chris Van Hollen, (D-MD-8th) which will foster skills building and career advancement for thousands of people with disabilities as well as providing the necessary data to expand successful practices nationwide.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Supports S. 2425 - Patient Access and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and complex rehab technology and accessories under Medicare's competitive acquisition program. Discussed with CMS consumer access problems with Medicare's competitive bidding program. United Spinal submitted comments to the Centers for Medicare and Medicaid Services regarding Medicaid access to covered services. United Spinal signed onto a comment letter to entities in the Federally-Facilitated Marketplaces, seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Marketplaces (FFMs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance for the disability population. United Spinal opposes the provision in the FY2017 Presidential Budget to provide authority to expand competitive bidding for certain durable medical equipment specifically: ostomy and urological supplies. United Spinal commented to CMS on the issue of discharge planning for hospitals, critical access hospitals, and home health agencies. This proposed rule would revise the discharge planning requirements in order to participate in the Medicare and Medicaid programs. United Spinal signed onto a letter to CMS opposing the same reimbursement to Medicare from skilled nursing facilities as well as in-patient rehab facilities and units (IRFs). United Spinal also edited and endorsed a letter from Congressman G. T. Thompson (R-PA) to the Centers for Medicare and Medicaid Services to urge Medicare Advantage plants to follow Medicare criteria Medicare IRF coverage criteria when determining coverage for IRF care. United Spinal signed onto a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the Summary of Benefits and Coverage, the Uniform Glossary of Medical Terms. United Spinal signed onto a letter to MedPAC on Medicare Part D cost sharing for LIS and dual eligible beneficiaries. Generic Utilization is already high in both LIS and non-LIS populations and higher cost sharing for branded products could reduce adherence, increase spending on other health care services in Medicare/Medicaid.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Conducted a Congressional Expo and Briefing on HR 1516/S. 1013 and H.R. 3229 and S. 2196 and educated Congress and the Government Accountability Office on the differences between manual and power CRT. United Spinal, as one of several consumer and disability stakeholders, raised concerns with the Administration for Community Living and the Centers for Medicare and Medicaid Services on access to durable medical equipment as urological and ostomy supplies with the expansion of competitive bidding under Medicare. United Spinal, in collaboration with United Spinals Urology Coalition, opposes expanding Medicares competitive bidding program to urology and ostomy supplies, as laid out in the Presidents Budget. United Spinal also sent a consumer and clinician letter to the committees of jurisdiction opposing the expansion. Part B Demonstration United Spinal signed onto two separate letters led by the Partnership to Improve Patient Care and the MS Coalition, to the Centers for Medicare and Medicaid Services opposing tying payment of drugs to cost-effectiveness. In early 2016, several bipartisan and nonpartisan organizations, including the Bipartisan Policy Center and the Long-Term Care Financing Collaborative, released reports on a path forward for future financing of our nations long-term care needs. The problem is clear: while our nation is aging and people are living longer with disabilities and chronic conditions, we lack a coherent plan on how to provide for their care and supports. Our current financing system relies almost entirely on Medicaid and unpaid family caregivers, both of which thwart family financial planning and hinder the economic opportunities of women, people of color, and people with disabilities. The Consortium for Citizens with Disabilities (CCD) Long-Term Services and Supports Task Force of CCD released a statement, which United Spinal endorsed, to weigh in on the recent reports on long-term care financing, express our support for Medicaid improvements, and support the emerging consensus on the need for a public insurance program. United Spinal signed onto an ITEM Coalition letter in support of HR 5210, the Protecting Patient Access to Durable Medical Equipment Act to Secretary Sylvia Burwell of the Department of Health and Human Services. This letter urged the Centers for Medicare and Medicaid Services (CMS) to extend the current six-month phase-in of modified payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for an additional 12 months to avoid disruption in care to beneficiaries. United Spinal is working on increasing coverage for powered exoskeleton devices and on a Congressional advocacy campaign to make Congress aware of research showing benefits to SCI individual in the use of these devices and to help powered exoskeleton devices gain and maintain regulatory approvals and additional insurance carrier recognition.

HR 3229/S. 2196 To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Spoke with Rep. Jared Polis district staff member regarding casework for a United Spinal member. H.R. 1516/S. 1013 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. A proposal in the Presidents FY2017 Budget expands the competitive bidding program to additional categories, including ostomy and urological supplies. This decision will limit access to prosthetic supplies which need to be clinically prescribed, selected, and/or adjusted and fitted for individuals by specially trained health care professionals based on the unique medical and physical needs of each person in relation to their disease or condition. The incorrect catheters or ostomy supplies can put individuals at risk of severe skin damage, infection, hospitalization and possibly death. Since ostomy and urological medical supplies restore the lost functions of waste storage and elimination, they are defined in the Social Security Act as prosthetics. United Spinal signed onto a letter, led by the Center for Medicare Advocacy, to the Centers for Medicare and Medicaid Services highlighting the problems with access to durable medical equipment (such as wheelchairs and other assistive technology and medical equipment that can be used in the home) when individuals are dual-eligibles - that is, on Medicare and Medicaid. There continues to be a misalignment of payment procedures in Medicare and Medicaid resulting in denials, delays, and higher than appropriate health care costs for essential DME among dually eligible beneficiaries. United Spinal supports the recommended solution which requires state Medicaid agencies, as is the law in Connecticut, to process prior authorization requests for DME for Medicaid beneficiaries whether or not they also are on Medicare. United Spinal signed onto a letter to the House in support of H.R. 5721, the Local Coverage Determination Clarification Act. This important legislation would help ensure basic procedural fairness in Local Coverage Determinations (LCDs), and thereby provide an important Medicare beneficiary protection that is often lacking in local coverage decisions. Competitive Bidding Letter United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services (CMS) supporting competitive bidding reforms including the requirement of DME provider state licensure; the letter states its opposition to the competitive bidding programs limits on choice, access and quality of durable medical equipment. Negative Pressure Wound Therapy United Spinal signed onto this CMS letter which focused on the proposal to implement the newly created statutory benefit to pay home health agencies separately for disposable negative pressure wound therapy. In general, the letter supports the Centers for Medicare and Medicaid Services (CMS) proposal implementing the new statutory benefit to ensure patient access to this important therapy. United Spinal signed onto and helped draft a letter to the Centers for Medicare and Medicaid Services opposing charging people with mobility impairments an extra payment for physician time. PAC VBP United Spinal signed onto this written statement on the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298) regarding Medicare Spending per Beneficiary (MSPB) measure. MSPB is an economic measure to assess Medicare utilization and is used to ascertain the productivity of a provider within a given setting, or a type of provider compared to another type of provider. The letter states that the PAC-VBP program should not measure MSPB without simultaneously measuring quality, function, and quality of life outcomes so that the Medicare program knows what it is getting for its payments to providers. ICD-10 United Spinal Association, and other stakeholders, requested an in-person meeting to discuss the unintended consequences of ICD-10 conversion on access to inpatient rehabilitation hospitals and units (IRFs) for Medicare beneficiaries with brain injuries and select orthopedic conditions, and to explore possible remedies to this problem. MPFS 2017 and OPPS 2017 United Spinal signed onto a couple of letters to the Centers for Medicare and Medicaid Services on related to various health IT provisions ensuring better protections of chronic care management services and streamlining tools for advanced imaging services.

HR 3229/S. 2196 To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Spoke with Rep. Jared Polis district staff member regarding casework for a United Spinal member. H.R. 1516/S. 1013 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. A proposal in the Presidents FY2017 Budget expands the competitive bidding program to additional categories, including ostomy and urological supplies. This decision will limit access to prosthetic supplies which need to be clinically prescribed, selected, and/or adjusted and fitted for individuals by specially trained health care professionals based on the unique medical and physical needs of each person in relation to their disease or condition. The incorrect catheters or ostomy supplies can put individuals at risk of severe skin damage, infection, hospitalization and possibly death. Since ostomy and urological medical supplies restore the lost functions of waste storage and elimination, they are defined in the Social Security Act as prosthetics. United Spinal signed onto a letter, led by the Center for Medicare Advocacy, to the Centers for Medicare and Medicaid Services highlighting the problems with access to durable medical equipment (such as wheelchairs and other assistive technology and medical equipment that can be used in the home) when individuals are dual-eligibles - that is, on Medicare and Medicaid. There continues to be a misalignment of payment procedures in Medicare and Medicaid resulting in denials, delays, and higher than appropriate health care costs for essential DME among dually eligible beneficiaries. United Spinal supports the recommended solution which requires state Medicaid agencies, as is the law in Connecticut, to process prior authorization requests for DME for Medicaid beneficiaries whether or not they also are on Medicare. United Spinal signed onto a letter to the House in support of H.R. 5721, the Local Coverage Determination Clarification Act. This important legislation would help ensure basic procedural fairness in Local Coverage Determinations (LCDs), and thereby provide an important Medicare beneficiary protection that is often lacking in local coverage decisions. Competitive Bidding Letter United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services (CMS) supporting competitive bidding reforms including the requirement of DME provider state licensure; the letter states its opposition to the competitive bidding programs limits on choice, access and quality of durable medical equipment. Negative Pressure Wound Therapy United Spinal signed onto this CMS letter which focused on the proposal to implement the newly created statutory benefit to pay home health agencies separately for disposable negative pressure wound therapy. In general, the letter supports the Centers for Medicare and Medicaid Services (CMS) proposal implementing the new statutory benefit to ensure patient access to this important therapy. United Spinal signed onto and helped draft a letter to the Centers for Medicare and Medicaid Services opposing charging people with mobility impairments an extra payment for physician time. PAC VBP United Spinal signed onto this written statement on the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298) regarding Medicare Spending per Beneficiary (MSPB) measure. MSPB is an economic measure to assess Medicare utilization and is used to ascertain the productivity of a provider within a given setting, or a type of provider compared to another type of provider. The letter states that the PAC-VBP program should not measure MSPB without simultaneously measuring quality, function, and quality of life outcomes so that the Medicare program knows what it is getting for its payments to providers. ICD-10 United Spinal Association, and other stakeholders, requested an in-person meeting to discuss the unintended consequences of ICD-10 conversion on access to inpatient rehabilitation hospitals and units (IRFs) for Medicare beneficiaries with brain injuries and select orthopedic conditions, and to explore possible remedies to this problem. MPFS 2017 and OPPS 2017 United Spinal signed onto a couple of letters to the Centers for Medicare and Medicaid Services on related to various health IT provisions ensuring better protections of chronic care management services and streamlining tools for advanced imaging services.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Conducted a Congressional Expo and Briefing on HR 1516/S. 1013 and H.R. 3229 and S. 2196 and educated Congress and the Government Accountability Office on the differences between manual and power CRT. United Spinal, as one of several consumer and disability stakeholders, raised concerns with the Administration for Community Living and the Centers for Medicare and Medicaid Services on access to durable medical equipment as urological and ostomy supplies with the expansion of competitive bidding under Medicare. United Spinal, in collaboration with United Spinals Urology Coalition, opposes expanding Medicares competitive bidding program to urology and ostomy supplies, as laid out in the Presidents Budget. United Spinal also sent a consumer and clinician letter to the committees of jurisdiction opposing the expansion. Part B Demonstration United Spinal signed onto two separate letters led by the Partnership to Improve Patient Care and the MS Coalition, to the Centers for Medicare and Medicaid Services opposing tying payment of drugs to cost-effectiveness. In early 2016, several bipartisan and nonpartisan organizations, including the Bipartisan Policy Center and the Long-Term Care Financing Collaborative, released reports on a path forward for future financing of our nations long-term care needs. The problem is clear: while our nation is aging and people are living longer with disabilities and chronic conditions, we lack a coherent plan on how to provide for their care and supports. Our current financing system relies almost entirely on Medicaid and unpaid family caregivers, both of which thwart family financial planning and hinder the economic opportunities of women, people of color, and people with disabilities. The Consortium for Citizens with Disabilities (CCD) Long-Term Services and Supports Task Force of CCD released a statement, which United Spinal endorsed, to weigh in on the recent reports on long-term care financing, express our support for Medicaid improvements, and support the emerging consensus on the need for a public insurance program. United Spinal signed onto an ITEM Coalition letter in support of HR 5210, the Protecting Patient Access to Durable Medical Equipment Act to Secretary Sylvia Burwell of the Department of Health and Human Services. This letter urged the Centers for Medicare and Medicaid Services (CMS) to extend the current six-month phase-in of modified payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for an additional 12 months to avoid disruption in care to beneficiaries. United Spinal is working on increasing coverage for powered exoskeleton devices and on a Congressional advocacy campaign to make Congress aware of research showing benefits to SCI individual in the use of these devices and to help powered exoskeleton devices gain and maintain regulatory approvals and additional insurance carrier recognition.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Supports S. 2425 - Patient Access and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and complex rehab technology and accessories under Medicare's competitive acquisition program. Discussed with CMS consumer access problems with Medicare's competitive bidding program. United Spinal submitted comments to the Centers for Medicare and Medicaid Services regarding Medicaid access to covered services. United Spinal signed onto a comment letter to entities in the Federally-Facilitated Marketplaces, seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Marketplaces (FFMs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance for the disability population. United Spinal opposes the provision in the FY2017 Presidential Budget to provide authority to expand competitive bidding for certain durable medical equipment specifically: ostomy and urological supplies. United Spinal commented to CMS on the issue of discharge planning for hospitals, critical access hospitals, and home health agencies. This proposed rule would revise the discharge planning requirements in order to participate in the Medicare and Medicaid programs. United Spinal signed onto a letter to CMS opposing the same reimbursement to Medicare from skilled nursing facilities as well as in-patient rehab facilities and units (IRFs). United Spinal also edited and endorsed a letter from Congressman G. T. Thompson (R-PA) to the Centers for Medicare and Medicaid Services to urge Medicare Advantage plants to follow Medicare criteria Medicare IRF coverage criteria when determining coverage for IRF care. United Spinal signed onto a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the Summary of Benefits and Coverage, the Uniform Glossary of Medical Terms. United Spinal signed onto a letter to MedPAC on Medicare Part D cost sharing for LIS and dual eligible beneficiaries. Generic Utilization is already high in both LIS and non-LIS populations and higher cost sharing for branded products could reduce adherence, increase spending on other health care services in Medicare/Medicaid.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 - Creates a separate benefit under Medicare for complex rehab technology. Supports H.R. 3229/S. 2196 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Supports S. 2425 - Patient Access and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and complex rehab technology and accessories under Medicare's competitive acquisition program. Discussed with CMS consumer access problems with Medicare's competitive bidding program. United Spinal submitted comments to the Centers for Medicare and Medicaid Services regarding Medicaid access to covered services. United Spinal signed onto a comment letter to entities in the Federally-Facilitated Marketplaces, seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Marketplaces (FFMs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance for the disability population. United Spinal opposes the provision in the FY2017 Presidential Budget to provide authority to expand competitive bidding for certain durable medical equipment specifically: ostomy and urological supplies. United Spinal commented to CMS on the issue of discharge planning for hospitals, critical access hospitals, and home health agencies. This proposed rule would revise the discharge planning requirements in order to participate in the Medicare and Medicaid programs. United Spinal signed onto a letter to CMS opposing the same reimbursement to Medicare from skilled nursing facilities as well as in-patient rehab facilities and units (IRFs). United Spinal also edited and endorsed a letter from Congressman G. T. Thompson (R-PA) to the Centers for Medicare and Medicaid Services to urge Medicare Advantage plants to follow Medicare criteria Medicare IRF coverage criteria when determining coverage for IRF care. United Spinal signed onto a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the Summary of Benefits and Coverage, the Uniform Glossary of Medical Terms. United Spinal signed onto a letter to MedPAC on Medicare Part D cost sharing for LIS and dual eligible beneficiaries. Generic Utilization is already high in both LIS and non-LIS populations and higher cost sharing for branded products could reduce adherence, increase spending on other health care services in Medicare/Medicaid.

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. HR 3975 Veterans Homebuyer Accessibility Act of 2015-this bill amends the Internal Revenue Code, with respect to the tax credit for first-time homebuyers, to: (1) allow a veteran of the Armed Forces a tax credit for 10% of the purchase price of a principal residence purchased prior to January 1, 2018; (2) allow an additional credit for the cost, not exceeding $8,000 in a taxable year, of installing special fixtures or movable facilities in a residence to accommodate a disability of the veteran; and (3) require a recapture of credit amounts if the veteran sells such residence within 36 months after purchasing it. S 2683-sent a letter to Senator Hirono to support this legislation which verifies that leave credited to such an employee is used for treating a service-connected disability, the employee shall certify to FAA Human Resource Management that the employee used that leave for purposes of being furnished treatment for that disability by a health care provider. Wrote a letter to Senator Durbin in support of an amendment to HR 2577 requiring the VA to flag colleges that are under investigation. Sent a letter to VA Health Services Research & Development in support of a VA study Improving Home Accessibility for Veterans with Disabilities.

Signed on to a joint letter of support of the National Defense Authorization Act for FY 2017, HR 4909, provision advocating protecting victims of military sexual trauma from non-disability mental health discharges from the military that give them other than honorable discharges - House and Senate HR 5620 Sent a letter of support to amend title 38, United States Code, to provide for the removal or demotion of employees of the Department of Veterans Affairs based on performance or misconduct, and for other purposes - House HR 5128 & S 3141 Protection & Advocacy for Veterans Act. Sent a letter of support of this legislation - a VA grant to improve the monitoring of mental health & substance abuse treatment programs of the Department of Veterans Affairs. - House and Senate Sent a letter for the Congressional record to VA Transportation & Infrastructure subcommittee requesting that they fund VA leases for VA medical facilities - House and Senate National Defense Authorization Act FY 2017, HR 4909 United Spinal signed onto a letter to the House and Senate Armed Services Committee regarding the FY 2017 National Defense Authorization Act (NDAA) opposing weakened provisions regarding the federal contractors that have violated Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA) - both of which address the recruiting and hiring of people with disabilities and veterans and other civil rights or labor laws when they bid on contracts. This provision is limited to contractors that have actually been debarred. This letter from the CCD Employment, Rights, and Veterans Task Forces urges the Armed Services committee leadership in both houses to remove the weakened provision. Doing so would hold federal contractors accountable for disability discrimination and discrimination against veterans (as well as violations of other laws).

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015. Wrote a letter to CDC advocating for a Traumatic Brain Injury (TBI) survey. United Spinal signed onto Senate Health Education Labor and Pensions comment letter, facilitated by the HEALTH IT Now Coalition, of which United Spinal is a member, supporting expanded use of telehealth for individuals living with stroke and for expanded prediabetes education. United Spinal is actively engaged in ensuring improved access to, and education of, all prescription drugs including biologic pharmaceuticals (organic compounds used to treat individuals with MS, SCI etc.) and has requested additional meetings with personnel from the U.S. Food and Drug Administration. United Spinal supports S.849 - Advancing Research for Neurological Diseases Act of 2015. This bill will mandate that the Centers for Disease Control and Prevention track the incidence and prevalence of neurological diseases. United Spinal supports S. 800/H.R. 1631 - Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act which better coordinates rehabilitation and disability research at the NIH. The Disability and Rehabilitation Research Coalition (DRRC), of which United Spinal is a member, offered comments in a letter to the Administration for Community Living, U.S. Department of Health and Human Services, on the proposed rule entitled, National Institute on Disability, Independent Living, and Rehabilitation Research. The proposed rule would implement the Workforce Innovation and Opportunity Act of 2014 which made significant changes to Title II (Research) of the Rehabilitation Act of 1973. It would also move NIDILRR from the Department of Education to the Department of Health and Human Services (Administration for Community Living). United Spinal submitted comments to the FDA Arthritis Advisory Committee meeting to raise concerns about a Remicade-luck drugs and the effects of ankylosing spondylitis.

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015. Wrote a letter to CDC advocating for a Traumatic Brain Injury (TBI) survey. United Spinal signed onto Senate Health Education Labor and Pensions comment letter, facilitated by the HEALTH IT Now Coalition, of which United Spinal is a member, supporting expanded use of telehealth for individuals living with stroke and for expanded prediabetes education. United Spinal is actively engaged in ensuring improved access to, and education of, all prescription drugs including biologic pharmaceuticals (organic compounds used to treat individuals with MS, SCI etc.) and has requested additional meetings with personnel from the U.S. Food and Drug Administration. United Spinal supports S.849 - Advancing Research for Neurological Diseases Act of 2015. This bill will mandate that the Centers for Disease Control and Prevention track the incidence and prevalence of neurological diseases. United Spinal supports S. 800/H.R. 1631 - Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act which better coordinates rehabilitation and disability research at the NIH. The Disability and Rehabilitation Research Coalition (DRRC), of which United Spinal is a member, offered comments in a letter to the Administration for Community Living, U.S. Department of Health and Human Services, on the proposed rule entitled, National Institute on Disability, Independent Living, and Rehabilitation Research. The proposed rule would implement the Workforce Innovation and Opportunity Act of 2014 which made significant changes to Title II (Research) of the Rehabilitation Act of 1973. It would also move NIDILRR from the Department of Education to the Department of Health and Human Services (Administration for Community Living). United Spinal submitted comments to the FDA Arthritis Advisory Committee meeting to raise concerns about a Remicade-luck drugs and the effects of ankylosing spondylitis.

HR 3016 Advocated against this bill because it caps funding for certain aviation degree programs and discriminates against veterans who want to train as rotary wing pilots. HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 2264/S 2596. Signed onto a letter of support to go in base National Defense Authorization Act for 100% disabled veterans (who had not retired from military service) to receive space available (Space A) on military flights. Liaised with numerous Congressional offices to inform them of the need to support HR 3229 Complex Rehabilitation Technology legislation. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. Signed onto a letter to Department of Labors Veterans Employment and Training Service to support its efforts to increase employment for veterans with disabilities. HR 4683 Wrote a letter in support of HR 4683 Fairness for Veterans Act that provides for the reevaluation of discharges for veterans released under other than honorable conditions due to the effects of traumatic brain injury or post-traumatic stress.

HR 385 HAVEN Act. Working with Congressman Al Greens office to make recommendations to Department of Housing and Urban Development for the implementation of a grant program that helps low income disabled veterans rehabilitate dilapidated buildings for use as residences. HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs-Wrote letter in support of this legislation to Congresswoman Walorski. Lobbied Congressional offices of the need to revamp VAs Vocational Rehabilitation and Employment Program (VR&E). The expectation is that by raising the disability rating qualification, the understaffed VR&E workforce can focus on those veterans most in need of services. HR 3975 Veterans Homebuyer Accessibility Act of 2015-this bill amends the Internal Revenue Code, with respect to the tax credit for first-time homebuyers, to: (1) allow a veteran of the Armed Forces a tax credit for 10% of the purchase price of a principal residence purchased prior to January 1, 2018; (2) allow an additional credit for the cost, not exceeding $8,000 in a taxable year, of installing special fixtures or movable facilities in a residence to accommodate a disability of the veteran; and (3) require a recapture of credit amounts if the veteran sells such residence within 36 months after purchasing it. S 2683-sent a letter to Senator Hirono to support this legislation which verifies that leave credited to such an employee is used for treating a service-connected disability, the employee shall certify to FAA Human Resource Management that the employee used that leave for purposes of being furnished treatment for that disability by a health care provider. Wrote a letter to Senator Durbin in support of an amendment to HR 2577 requiring the VA to flag colleges that are under investigation. Sent a letter to VA Health Services Research & Development in support of a VA study Improving Home Accessibility for Veterans with Disabilities.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

United Spinal Association calls for FDA Oversight and Congressional Hearings on Biologic Medicines Biologic medicines are made from living organisms and are far more complex and difficult to develop than traditional chemical drugs. United Spinal signed onto a Congressional letter to ask for support for the inclusion of $38 million in the FY 2016 Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. Funding provided through the AT Act supports programs that assure people with disabilities have access to and acquisition of the assistive technology services they need to live, work, and attend school in their communities. United Spinal wrote a Congressional letter in support of The Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act (companion bills: S. 800 and H.R. 1631) to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). Support HR 292, Advancing Research for Neurological Diseases Act of 2015, which amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System and requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. United Spinal signed on to a letter organized by the Autistic Self Advocacy Network to be sent to the Federal Drug Administration (FDA). The letter urged the FDA to act on the recommendations of the Neurological Devices Panel of the Medical Devices Advisory Committee that the harms of aversive conditioning devices used for contingent electric shock outweigh any potential benefits. The letter signatories called for the FDA to issue a total ban on any aversive conditioning devices used for contingent electric shock, in order to protect the publics right to safe, evidence-based treatment and the inherent human rights and dignity of people with disabilities. United Spinal Association signed onto an ARCH National Respite Network letter for House and Senate funding requests for FY2016 for the Labor/HHS/Education Appropriations bill for respite and other critical family support programs that provide a safety net for family caregivers across the lifespan and provides savings with proven prevention strategies. The letter requests $5.0 million for the Lifespan Respite Care Program, the amount included in the Presidents FY 2016 budget. We are also seeking support for the National Family Caregiver Support Program ($150 million), the Native American Caregiver Support Program ($6.8 million), and for the new Family Support program ($15 million) proposed by the President. United Spinal commended the United States House of Representatives Committee on Energy & Commerce Committee in support of the $10 billion NIH Innovation Fund which was added to a second discussion draft of the 21st Century Cures Act which makes improvements with access to medical devices, and prescription drugs. United Spinal policy staff requested members of Congress on the House and Senate Appropriations Committees to assist with United Spinal taking a leading role with an Administration for Community Living (ACL) federal $19,589,469 multi-year grant that funds a national Paralysis Resource Center (PRC) to provide access to the most comprehensive, high quality information and supports for people of all ages living with paralysis, their family and caregivers. United Spinal supports efforts by the American Academy of Pain Management and signed onto their letter to the Senate Finance Committee in implementing the development of a comprehensive population-level strategy to advance pain research, education, care and prevention, called the National Pain Strategy (NPS).

Discussed the FY 2016 National Defense Authorization Act HR 1735, FY 2016 National Defense Authorization Bill, Space Available Transportation Disabled Vets legislation Supported HR 1735 FY 2016 National Defense Authorization Bill amendment #1556, The Servicemember Student Loan Affordability Act of 2015 Supported House efforts to increase DoD and VA support for Joint Centers of Excellence.

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015 Amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System. Requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. Support HR 1969 Military and Veteran Caregiver Services Improvement Act. This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs (VA) to include members of the Armed Forces or veterans who are seriously injured or who became ill on active duty prior to September 11, 2001. United Spinal submitted RFI comments as a member of the Disability and Rehabilitation Research Coalition as well as independently: "Inviting Comments and Suggestions on the Priorities specified for the NIH-wide Rehabilitation Research Plan". Support Lifespan Respite Reauthorization Act , HR 3913 and the Military and Veteran Caregiver Services Improvement Act (S. 1085 & HR 1969 - includes provisions to reauthorize the Lifespan Respite Care Program. Support S. 2141 - Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 - To amend the Public Health Service Act with respect to health information technology. Advocate for repeal of medical device tax. Submitted a comment letter to the FDA regarding the announcement of the establishment of their Patient Engagement Advisory Committee and stated our availability to help the FDA regarding patient preference information, benefit-risk determinations and clinical trial or registry design.

Wrote Testimony in support of HR 353-Veterans Access to Hearing Health Act. Wrote OpEd in support of H.R. 1994- The VA Accountability Act of 2015. Discussed VA Health Care Budget Shortfall and System Shutdown. This is an area of concern that if VA is not properly funded, certain services will not be available for veterans. Discussed the needs of military and veteran caregivers at a US Chamber of Commerce hosted event Discussed the VA Office of Inspector Generals Final Report on the Inappropriate Use of Position and the Misuse of the Relocation Program and Incentives in preparation for Oct 21 testimony before the House Committee on Veterans Affairs. Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families.

Wrote Testimony in support of HR 353-Veterans Access to Hearing Health Act. Wrote OpEd in support of H.R. 1994- The VA Accountability Act of 2015. Discussed VA Health Care Budget Shortfall and System Shutdown. This is an area of concern that if VA is not properly funded, certain services will not be available for veterans. Discussed the needs of military and veteran caregivers at a US Chamber of Commerce hosted event Discussed the VA Office of Inspector Generals Final Report on the Inappropriate Use of Position and the Misuse of the Relocation Program and Incentives in preparation for Oct 21 testimony before the House Committee on Veterans Affairs. Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families.

Wrote Testimony in support of HR 353-Veterans Access to Hearing Health Act. Wrote OpEd in support of H.R. 1994- The VA Accountability Act of 2015. Discussed VA Health Care Budget Shortfall and System Shutdown. This is an area of concern that if VA is not properly funded, certain services will not be available for veterans. Discussed the needs of military and veteran caregivers at a US Chamber of Commerce hosted event Discussed the VA Office of Inspector Generals Final Report on the Inappropriate Use of Position and the Misuse of the Relocation Program and Incentives in preparation for Oct 21 testimony before the House Committee on Veterans Affairs. Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families.

Signed onto a Coalition Letter for Sign On Opposing Legislation to Repeal Gainful Employment and Incentive Compensation Rule. Signed on to a letter to Secretary of Education Duncan requesting a discharge of student loans based on Corinthian College going out of business and leaving its veteran students saddled with debt and no degree. Signed on to support HR 2360, the Career-ready Student Veterans Act. Provided support to Senator Blumenthals Bill to restore Post-9/11 education benefits for veterans at closed schools. Released a press statement in support of Military and Veterans Education Protection Act of 2015, legislation introduced by Senators Carper, Durbin and Blumenthal that proposes to close the 90-10 Loophole in veteran education benefits.

Signed on to support HR 2360, the Career-ready Student Veterans Act Submitted a statement for the record about H.R.475, The GI Bill Processing Improvement Act of 2015. Signed onto a letter to Secretary Duncan to urge that the Department of Education alert consumers if a school is the subject of public federal or state investigations, lawsuits, or settlements Signed on to a letter in support of the Pell Restoration Act of 2015, a bill to amend the Higher Education Act of 1965 to clarify the Federal Pell Grant duration limits of borrowers who attend an institution of higher education that closes or commits fraud or other misconduct, and for other purposes.

Signed on to support HR 2360, the Career-ready Student Veterans Act Submitted a statement for the record about H.R.475, The GI Bill Processing Improvement Act of 2015. Signed onto a letter to Secretary Duncan to urge that the Department of Education alert consumers if a school is the subject of public federal or state investigations, lawsuits, or settlements Signed on to a letter in support of the Pell Restoration Act of 2015, a bill to amend the Higher Education Act of 1965 to clarify the Federal Pell Grant duration limits of borrowers who attend an institution of higher education that closes or commits fraud or other misconduct, and for other purposes.

Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families. Discussed how to transform VAs vocational rehabilitation program into a 21st century vocational rehabilitation program. Discussed proposed legislation to provide a presumption of service connection for mental health conditions related to military sexual trauma. Discussed proposed legislation regarding telework for certain VA employees. Supported House efforts to increase DOD and VA support for Joint Centers of Excellence. Discussed reforming the VAs claims process to ensure that it is veteran-centered. Discussed with advocates a legislative proposal to expand the approved uses of the Post 9/11 GI Bill. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Wrote a letter of support for HR 2894 CARE For All Veterans Act Wrote a letter in support of HR 2360, the Career-Ready Student Veterans Act

Signed on to support HR 2360, the Career-ready Student Veterans Act Submitted a statement for the record about H.R.475, The GI Bill Processing Improvement Act of 2015. Signed onto a letter to Secretary Duncan to urge that the Department of Education alert consumers if a school is the subject of public federal or state investigations, lawsuits, or settlements Signed on to a letter in support of the Pell Restoration Act of 2015, a bill to amend the Higher Education Act of 1965 to clarify the Federal Pell Grant duration limits of borrowers who attend an institution of higher education that closes or commits fraud or other misconduct, and for other purposes.

Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families. Discussed how to transform VAs vocational rehabilitation program into a 21st century vocational rehabilitation program. Discussed proposed legislation to provide a presumption of service connection for mental health conditions related to military sexual trauma. Discussed proposed legislation regarding telework for certain VA employees. Supported House efforts to increase DOD and VA support for Joint Centers of Excellence. Discussed reforming the VAs claims process to ensure that it is veteran-centered. Discussed with advocates a legislative proposal to expand the approved uses of the Post 9/11 GI Bill. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Wrote a letter of support for HR 2894 CARE For All Veterans Act Wrote a letter in support of HR 2360, the Career-Ready Student Veterans Act

United Spinal Association calls for FDA Oversight and Congressional Hearings on Biologic Medicines Biologic medicines are made from living organisms and are far more complex and difficult to develop than traditional chemical drugs. United Spinal signed onto a Congressional letter to ask for support for the inclusion of $38 million in the FY 2016 Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. Funding provided through the AT Act supports programs that assure people with disabilities have access to and acquisition of the assistive technology services they need to live, work, and attend school in their communities. United Spinal wrote a Congressional letter in support of The Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act (companion bills: S. 800 and H.R. 1631) to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). Support HR 292, Advancing Research for Neurological Diseases Act of 2015, which amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System and requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. United Spinal signed on to a letter organized by the Autistic Self Advocacy Network to be sent to the Federal Drug Administration (FDA). The letter urged the FDA to act on the recommendations of the Neurological Devices Panel of the Medical Devices Advisory Committee that the harms of aversive conditioning devices used for contingent electric shock outweigh any potential benefits. The letter signatories called for the FDA to issue a total ban on any aversive conditioning devices used for contingent electric shock, in order to protect the publics right to safe, evidence-based treatment and the inherent human rights and dignity of people with disabilities. United Spinal Association signed onto an ARCH National Respite Network letter for House and Senate funding requests for FY2016 for the Labor/HHS/Education Appropriations bill for respite and other critical family support programs that provide a safety net for family caregivers across the lifespan and provides savings with proven prevention strategies. The letter requests $5.0 million for the Lifespan Respite Care Program, the amount included in the Presidents FY 2016 budget. We are also seeking support for the National Family Caregiver Support Program ($150 million), the Native American Caregiver Support Program ($6.8 million), and for the new Family Support program ($15 million) proposed by the President. United Spinal commended the United States House of Representatives Committee on Energy & Commerce Committee in support of the $10 billion NIH Innovation Fund which was added to a second discussion draft of the 21st Century Cures Act which makes improvements with access to medical devices, and prescription drugs. United Spinal policy staff requested members of Congress on the House and Senate Appropriations Committees to assist with United Spinal taking a leading role with an Administration for Community Living (ACL) federal $19,589,469 multi-year grant that funds a national Paralysis Resource Center (PRC) to provide access to the most comprehensive, high quality information and supports for people of all ages living with paralysis, their family and caregivers. United Spinal supports efforts by the American Academy of Pain Management and signed onto their letter to the Senate Finance Committee in implementing the development of a comprehensive population-level strategy to advance pain research, education, care and prevention, called the National Pain Strategy (NPS).

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015 Amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System. Requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. Support HR 1969 Military and Veteran Caregiver Services Improvement Act. This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs (VA) to include members of the Armed Forces or veterans who are seriously injured or who became ill on active duty prior to September 11, 2001. United Spinal submitted RFI comments as a member of the Disability and Rehabilitation Research Coalition as well as independently: "Inviting Comments and Suggestions on the Priorities specified for the NIH-wide Rehabilitation Research Plan". Support Lifespan Respite Reauthorization Act , HR 3913 and the Military and Veteran Caregiver Services Improvement Act (S. 1085 & HR 1969 - includes provisions to reauthorize the Lifespan Respite Care Program. Support S. 2141 - Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 - To amend the Public Health Service Act with respect to health information technology. Advocate for repeal of medical device tax. Submitted a comment letter to the FDA regarding the announcement of the establishment of their Patient Engagement Advisory Committee and stated our availability to help the FDA regarding patient preference information, benefit-risk determinations and clinical trial or registry design.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Wrote Testimony in support of HR 353-Veterans Access to Hearing Health Act. Wrote OpEd in support of H.R. 1994- The VA Accountability Act of 2015. Discussed VA Health Care Budget Shortfall and System Shutdown. This is an area of concern that if VA is not properly funded, certain services will not be available for veterans. Discussed the needs of military and veteran caregivers at a US Chamber of Commerce hosted event Discussed the VA Office of Inspector Generals Final Report on the Inappropriate Use of Position and the Misuse of the Relocation Program and Incentives in preparation for Oct 21 testimony before the House Committee on Veterans Affairs. Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families.

Wrote Testimony in support of HR 353-Veterans Access to Hearing Health Act. Wrote OpEd in support of H.R. 1994- The VA Accountability Act of 2015. Discussed VA Health Care Budget Shortfall and System Shutdown. This is an area of concern that if VA is not properly funded, certain services will not be available for veterans. Discussed the needs of military and veteran caregivers at a US Chamber of Commerce hosted event Discussed the VA Office of Inspector Generals Final Report on the Inappropriate Use of Position and the Misuse of the Relocation Program and Incentives in preparation for Oct 21 testimony before the House Committee on Veterans Affairs. Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families.

Wrote Testimony in support of HR 353-Veterans Access to Hearing Health Act. Wrote OpEd in support of H.R. 1994- The VA Accountability Act of 2015. Discussed VA Health Care Budget Shortfall and System Shutdown. This is an area of concern that if VA is not properly funded, certain services will not be available for veterans. Discussed the needs of military and veteran caregivers at a US Chamber of Commerce hosted event Discussed the VA Office of Inspector Generals Final Report on the Inappropriate Use of Position and the Misuse of the Relocation Program and Incentives in preparation for Oct 21 testimony before the House Committee on Veterans Affairs. Discussed the change in the 40 mile rule with Veterans Health Administration (VHA) Discussed how to address transportation difficulties experienced by veterans needing to travel to VA healthcare appointments. Discussed draft legislation that would improve benefits and services for veterans and their families.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015 Amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System. Requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. Support HR 1969 Military and Veteran Caregiver Services Improvement Act. This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs (VA) to include members of the Armed Forces or veterans who are seriously injured or who became ill on active duty prior to September 11, 2001. United Spinal submitted RFI comments as a member of the Disability and Rehabilitation Research Coalition as well as independently: "Inviting Comments and Suggestions on the Priorities specified for the NIH-wide Rehabilitation Research Plan". Support Lifespan Respite Reauthorization Act , HR 3913 and the Military and Veteran Caregiver Services Improvement Act (S. 1085 & HR 1969 - includes provisions to reauthorize the Lifespan Respite Care Program. Support S. 2141 - Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 - To amend the Public Health Service Act with respect to health information technology. Advocate for repeal of medical device tax. Submitted a comment letter to the FDA regarding the announcement of the establishment of their Patient Engagement Advisory Committee and stated our availability to help the FDA regarding patient preference information, benefit-risk determinations and clinical trial or registry design.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

United Spinal Association signed onto a letter, facilitated by the National Academy of Elder Law Attorneys, to Department of Housing and Urban Development, out of concern that public housing authorities (PHAs) and other rental assistance program administrators are interpreting national HUD policy to be that all distributions from special needs trusts are income for HUD rental assistance programs. The letter stated that HUD rules, in light of special needs trust law and policy, require that distributions from special needs trusts not be counted as income. Support H.R. 3975, the Veterans Homebuyer Accessibility Act - The bill would authorize a veteran first-time homebuyers tax credit equal to 10 percent of the purchase price of the residence and an adaptive housing credit of up to $8,000 for veterans to address structural and other changes to their home to accommodate their disabilities.

Signed on to support HR 2360, the Career-ready Student Veterans Act Submitted a statement for the record about H.R.475, The GI Bill Processing Improvement Act of 2015. Signed onto a letter to Secretary Duncan to urge that the Department of Education alert consumers if a school is the subject of public federal or state investigations, lawsuits, or settlements Signed on to a letter in support of the Pell Restoration Act of 2015, a bill to amend the Higher Education Act of 1965 to clarify the Federal Pell Grant duration limits of borrowers who attend an institution of higher education that closes or commits fraud or other misconduct, and for other purposes.

Signed on to support HR 2360, the Career-ready Student Veterans Act Submitted a statement for the record about H.R.475, The GI Bill Processing Improvement Act of 2015. Signed onto a letter to Secretary Duncan to urge that the Department of Education alert consumers if a school is the subject of public federal or state investigations, lawsuits, or settlements Signed on to a letter in support of the Pell Restoration Act of 2015, a bill to amend the Higher Education Act of 1965 to clarify the Federal Pell Grant duration limits of borrowers who attend an institution of higher education that closes or commits fraud or other misconduct, and for other purposes.

Signed on to support HR 2360, the Career-ready Student Veterans Act Submitted a statement for the record about H.R.475, The GI Bill Processing Improvement Act of 2015. Signed onto a letter to Secretary Duncan to urge that the Department of Education alert consumers if a school is the subject of public federal or state investigations, lawsuits, or settlements Signed on to a letter in support of the Pell Restoration Act of 2015, a bill to amend the Higher Education Act of 1965 to clarify the Federal Pell Grant duration limits of borrowers who attend an institution of higher education that closes or commits fraud or other misconduct, and for other purposes.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Supports H.R. 1516/S. 1013 - Ensuring Access to Quality Complex Rehabilitation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. Supports H.R.3229 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Opposes CMS' Miscellaneous Coding policy which limits access to wheelchair accessories based on whether the price of that accessory exceeds $150 [Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)]. The HAB Coalition discussed with CMS the provision of habilitation benefits at the federal and state levels and asking for better clarification on coverage to include habilitative devices. United Spinal Association signed on to letters as part of the Coalition to Preserve Rehabilitation Steering Committee to the Centers for Medicare and Medicaid Services opposing bundling payments of episodes of care for Medicare beneficiaries and opposing restrictive lower limb prosthesis policy. United Spinal staff was interviewed by the U.S. Government Accountability Office on the impact of Medicares competitive acquisition program on people with disabilities for their 2015 report. United Spinal continues to monitor the impact of the program on access issues for Medicare beneficiaries. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal supports strengthening consumer protections in rehab facilities and urged Medicare to establish stronger language around resident services provided with clearer definitions; stronger language around comprehensive person-centered planning urging CMS to add that if facility discharge is determined to not be feasible, the plan must document the specific reasons for that conclusion, the services that resident receives and the reasons why those services could not be provided; better definition around the provision of rehabilitative services, discharge planning and resident rights for example. United Spinal also signed onto an American Association for Justice letter urging CMS to remove pre-dispute arbitration clauses as inherently unfair and disadvantageous to nursing home residents. First and foremost, an essential component of any decision-making process is gathering the information needed to make the best decision. Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute, for example, in cases of alleged severe neglect, serious injuries or death.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015 Amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System. Requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. Support HR 1969 Military and Veteran Caregiver Services Improvement Act. This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs (VA) to include members of the Armed Forces or veterans who are seriously injured or who became ill on active duty prior to September 11, 2001. United Spinal submitted RFI comments as a member of the Disability and Rehabilitation Research Coalition as well as independently: "Inviting Comments and Suggestions on the Priorities specified for the NIH-wide Rehabilitation Research Plan". Support Lifespan Respite Reauthorization Act , HR 3913 and the Military and Veteran Caregiver Services Improvement Act (S. 1085 & HR 1969 - includes provisions to reauthorize the Lifespan Respite Care Program. Support S. 2141 - Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 - To amend the Public Health Service Act with respect to health information technology. Advocate for repeal of medical device tax. Submitted a comment letter to the FDA regarding the announcement of the establishment of their Patient Engagement Advisory Committee and stated our availability to help the FDA regarding patient preference information, benefit-risk determinations and clinical trial or registry design.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015 Amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System. Requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. Support HR 1969 Military and Veteran Caregiver Services Improvement Act. This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs (VA) to include members of the Armed Forces or veterans who are seriously injured or who became ill on active duty prior to September 11, 2001. United Spinal submitted RFI comments as a member of the Disability and Rehabilitation Research Coalition as well as independently: "Inviting Comments and Suggestions on the Priorities specified for the NIH-wide Rehabilitation Research Plan". Support Lifespan Respite Reauthorization Act , HR 3913 and the Military and Veteran Caregiver Services Improvement Act (S. 1085 & HR 1969 - includes provisions to reauthorize the Lifespan Respite Care Program. Support S. 2141 - Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 - To amend the Public Health Service Act with respect to health information technology. Advocate for repeal of medical device tax. Submitted a comment letter to the FDA regarding the announcement of the establishment of their Patient Engagement Advisory Committee and stated our availability to help the FDA regarding patient preference information, benefit-risk determinations and clinical trial or registry design.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Submitted testimony in support of HR 353-Veterans Access to Hearing Health Act. This bill is designed to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes. Wrote a letter of support for HR 3970, Housing our Heroes Act that would provide funding for a test program designed to renovate abandoned property to provide housing for veterans Liaised with numerous Congressional offices to inform them of the need to support H.R. 3229/S.2196 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Support HR 3471 Veterans Mobility Safety Act- this bill is to amend title 38, United States Code, to make certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans Affairs. Support S.1203 This is a bill to amend title 38, United States Code, to improve the furnishing of health care to veterans by the Department of Veterans Affairs, to improve the processing by the Department of claims for disability compensation, and for other purposes. Support S. 1021 Wounded Warrior Workforce Enhancement Act- A bill to require the Secretary of Veterans Affairs to award grants to establish, or expand upon, master's degree programs in orthotics and prosthetics, and for other purposes. S. 1022 Wounded Warrior Research Enhancement Act- This bill directs the Secretary of Defense to award research grants for: actions that can be taken to prevent amputation of limbs, the most effective point for orthotic and prosthetic intervention during patient treatment, orthotic interventions that are most effective in treating the physical effects of traumatic brain injury, patients that benefit most from particular orthotic and prosthetic technologies, orthotic and prosthetic services that best facilitate the return to active duty of members of the Armed Forces, and the effect of aging on the use of prosthetics.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

United Spinal Association calls for FDA Oversight and Congressional Hearings on Biologic Medicines Biologic medicines are made from living organisms and are far more complex and difficult to develop than traditional chemical drugs. United Spinal signed onto a Congressional letter to ask for support for the inclusion of $38 million in the FY 2016 Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. Funding provided through the AT Act supports programs that assure people with disabilities have access to and acquisition of the assistive technology services they need to live, work, and attend school in their communities. United Spinal wrote a Congressional letter in support of The Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act (companion bills: S. 800 and H.R. 1631) to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). Support HR 292, Advancing Research for Neurological Diseases Act of 2015, which amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System and requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. United Spinal signed on to a letter organized by the Autistic Self Advocacy Network to be sent to the Federal Drug Administration (FDA). The letter urged the FDA to act on the recommendations of the Neurological Devices Panel of the Medical Devices Advisory Committee that the harms of aversive conditioning devices used for contingent electric shock outweigh any potential benefits. The letter signatories called for the FDA to issue a total ban on any aversive conditioning devices used for contingent electric shock, in order to protect the publics right to safe, evidence-based treatment and the inherent human rights and dignity of people with disabilities. United Spinal Association signed onto an ARCH National Respite Network letter for House and Senate funding requests for FY2016 for the Labor/HHS/Education Appropriations bill for respite and other critical family support programs that provide a safety net for family caregivers across the lifespan and provides savings with proven prevention strategies. The letter requests $5.0 million for the Lifespan Respite Care Program, the amount included in the Presidents FY 2016 budget. We are also seeking support for the National Family Caregiver Support Program ($150 million), the Native American Caregiver Support Program ($6.8 million), and for the new Family Support program ($15 million) proposed by the President. United Spinal commended the United States House of Representatives Committee on Energy & Commerce Committee in support of the $10 billion NIH Innovation Fund which was added to a second discussion draft of the 21st Century Cures Act which makes improvements with access to medical devices, and prescription drugs. United Spinal policy staff requested members of Congress on the House and Senate Appropriations Committees to assist with United Spinal taking a leading role with an Administration for Community Living (ACL) federal $19,589,469 multi-year grant that funds a national Paralysis Resource Center (PRC) to provide access to the most comprehensive, high quality information and supports for people of all ages living with paralysis, their family and caregivers. United Spinal supports efforts by the American Academy of Pain Management and signed onto their letter to the Senate Finance Committee in implementing the development of a comprehensive population-level strategy to advance pain research, education, care and prevention, called the National Pain Strategy (NPS).

Support H.R. 292/S. 849 - Advancing Research for Neurological Diseases Act of 2015 Amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System. Requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. Support HR 1969 Military and Veteran Caregiver Services Improvement Act. This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs (VA) to include members of the Armed Forces or veterans who are seriously injured or who became ill on active duty prior to September 11, 2001. United Spinal submitted RFI comments as a member of the Disability and Rehabilitation Research Coalition as well as independently: "Inviting Comments and Suggestions on the Priorities specified for the NIH-wide Rehabilitation Research Plan". Support Lifespan Respite Reauthorization Act , HR 3913 and the Military and Veteran Caregiver Services Improvement Act (S. 1085 & HR 1969 - includes provisions to reauthorize the Lifespan Respite Care Program. Support S. 2141 - Transparent Ratings on Usability and Security to Transform Information Technology (TRUST IT) Act of 2015 - To amend the Public Health Service Act with respect to health information technology. Advocate for repeal of medical device tax. Submitted a comment letter to the FDA regarding the announcement of the establishment of their Patient Engagement Advisory Committee and stated our availability to help the FDA regarding patient preference information, benefit-risk determinations and clinical trial or registry design.