JASEY CARDENAS

H.R. 3208/S. 1755: Real Emergency Access for Aging and Disability Inclusion for Disasters Act Signed onto letter of support as part of the Coalition of Citizens with Disabilities in support of the RE-AADI Act which aims to ensure that older adults and individuals with disabilities are prepared for disasters, and for other purposes.

United Spinal supports the Disability Integration Act (DIA) - S.117/H.R. 555 specifies in Federal Statute that people with disabilities have a federally protected right to a real choice in how and where they receive services and supports.

United Spinal supports the Disability Integration Act (DIA) - S.117/H.R. 555 specifies in Federal Statute that people with disabilities have a federally protected right to a real choice in how and where they receive services and supports.

Outreach to new Members of Congress and committees of jurisdiction on the need to reform rehabilitation access, therapy and expertise for the spinal cord injury. Was asked by the Congressional Telehealth Caucus to submit comments on their RFI on telemedicine, which we did, highlighting the specific needs of access to healthcare and the challenges that our population face with reaching medical experts. Submitted appropriations requests for robust funding to the Hill for the SCI Research Program and the MS Research program at the Department of Defense. National Institutes of Health (NIH) - National Institute for Neurological Disorders and Stroke (NINDS) SCI 2020: Launching a Decade for Disruption in Spinal Cord Injury Research - Post SCI 2020 Call - Had a meaningful discussion with NIH about research priorities for the SCI population and discussed our efforts to advocate on establishing SCI Centers of Excellence. National Institute on Neurological Disorders and Strokes (NINDS) Nonprofit Forum 2019: Progress through Partnership United Spinal Policy staff participated in the Progress through Partnership Forum which provided an opportunity for nonprofit leaders to network with colleagues and to engage in discussions with NINDS staff. The agenda featured panel discussions on cell and gene therapy, data collection and storage, motivating the next generation of researchers, neuroethics and success stories. National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) United Spinal policy staff met, along with numerous other disability organizations as members of the Disability Rehabilitation Research Coalition, to outline rehabilitation research priorities to the new director, Jim Whitehead. United Spinal policy staff emphasized fitness, exercise, nutrition and maximizing consumer outcomes from acute care and rehabilitation programs. United Spinal supports and signed onto letters to Congress on H.R.2073 and S. 110 (The Medical Expense Savings Act) - amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. HHS - Administration for Community Living United Spinal signed onto CCDs letter to the U.S. Department of Health and Human Services ACL to oppose the ACL reorganization which is supposed to improve efficiency and effectiveness of the organization; strengthen infrastructure; and improve the connections between the organization and its stakeholder, grantees and consumers at the national, state and local levels. CCD is concerned that the reorganization plan may have the opposite result. HHS - Office of the National Coordinator for Health IT As a member of the Personal Connected Health Alliance (PCHAlliance), a non-profit membership association, United Spinal joined in commenting on the proposed rule, titled 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, published in the Federal Register on March 4, 2019. The letter read in part: PCHAlliance appreciates ONCs extensive work to develop consensus around interoperability standards. Consensus-based standards, certification programs, and policies comprise the essential backbone to enable interoperability and the broad sharing of health care information to support and improve health care delivery, decision-making, and operations. NIH United Spinal submitted comments addressing the National Center for Medical Rehabilitation Researchs Request for Information: Research Plan on Rehabilitation. The comments read in part: We echo the comments we joined in submitting as a member of the Disability Rehabilitation Research Consortium (DRRC), the plan should ensure an understanding of rehabilitation research that is cross-cutting, multi-disciplinary, and focused on 1) understanding the mechanisms of disability, 2) supporting efforts to restore and improve functional capacity in individuals undergoing rehabilitation, and 3) maintaining and preventing deterioration of functional skills while enhancing quality of life for people with disabilities. 21st Century Assistive Technology Bill/S. 1835. Submitted letter of support to Senator Caseys office for the introduction for the 21st Century Assistive Technology Act which would help address the need for increased education of and access to the latest assistive technology devices, particularly for people with disabilities living in rural regions. United Spinal sent in comments to Rep. Suzan DelBene (D-WA) on telemedicine restrictions regarding telehealth policies in her bill entitled Mental Health Telemedicine Expansion Act/H.R. 1301 and highlighted our opposition to in-person visit requirements.

United Spinal supports the Disability Integration Act (DIA) - S.117/H.R. 555 specifies in Federal Statute that people with disabilities have a federally protected right to a real choice in how and where they receive services and supports.

United Spinal supports the Disability Integration Act (DIA) - S.117/H.R. 555 specifies in Federal Statute that people with disabilities have a federally protected right to a real choice in how and where they receive services and supports.

H.R. 3208/S. 1755: Real Emergency Access for Aging and Disability Inclusion for Disasters Act Signed onto letter of support as part of the Coalition of Citizens with Disabilities in support of the RE-AADI Act which aims to ensure that older adults and individuals with disabilities are prepared for disasters, and for other purposes.

Outreach to new Members of Congress and committees of jurisdiction on the need to reform rehabilitation access, therapy and expertise for the spinal cord injury. Was asked by the Congressional Telehealth Caucus to submit comments on their RFI on telemedicine, which we did, highlighting the specific needs of access to healthcare and the challenges that our population face with reaching medical experts. Submitted appropriations requests for robust funding to the Hill for the SCI Research Program and the MS Research program at the Department of Defense. National Institutes of Health (NIH) - National Institute for Neurological Disorders and Stroke (NINDS) SCI 2020: Launching a Decade for Disruption in Spinal Cord Injury Research - Post SCI 2020 Call - Had a meaningful discussion with NIH about research priorities for the SCI population and discussed our efforts to advocate on establishing SCI Centers of Excellence. National Institute on Neurological Disorders and Strokes (NINDS) Nonprofit Forum 2019: Progress through Partnership United Spinal Policy staff participated in the Progress through Partnership Forum which provided an opportunity for nonprofit leaders to network with colleagues and to engage in discussions with NINDS staff. The agenda featured panel discussions on cell and gene therapy, data collection and storage, motivating the next generation of researchers, neuroethics and success stories. National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) United Spinal policy staff met, along with numerous other disability organizations as members of the Disability Rehabilitation Research Coalition, to outline rehabilitation research priorities to the new director, Jim Whitehead. United Spinal policy staff emphasized fitness, exercise, nutrition and maximizing consumer outcomes from acute care and rehabilitation programs. United Spinal supports and signed onto letters to Congress on H.R.2073 and S. 110 (The Medical Expense Savings Act) - amend the Internal Revenue Code of 1986 to permanently extend the 7.5 percent adjusted gross income floor for the medical expense deduction. HHS - Administration for Community Living United Spinal signed onto CCDs letter to the U.S. Department of Health and Human Services ACL to oppose the ACL reorganization which is supposed to improve efficiency and effectiveness of the organization; strengthen infrastructure; and improve the connections between the organization and its stakeholder, grantees and consumers at the national, state and local levels. CCD is concerned that the reorganization plan may have the opposite result. HHS - Office of the National Coordinator for Health IT As a member of the Personal Connected Health Alliance (PCHAlliance), a non-profit membership association, United Spinal joined in commenting on the proposed rule, titled 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, published in the Federal Register on March 4, 2019. The letter read in part: PCHAlliance appreciates ONCs extensive work to develop consensus around interoperability standards. Consensus-based standards, certification programs, and policies comprise the essential backbone to enable interoperability and the broad sharing of health care information to support and improve health care delivery, decision-making, and operations. NIH United Spinal submitted comments addressing the National Center for Medical Rehabilitation Researchs Request for Information: Research Plan on Rehabilitation. The comments read in part: We echo the comments we joined in submitting as a member of the Disability Rehabilitation Research Consortium (DRRC), the plan should ensure an understanding of rehabilitation research that is cross-cutting, multi-disciplinary, and focused on 1) understanding the mechanisms of disability, 2) supporting efforts to restore and improve functional capacity in individuals undergoing rehabilitation, and 3) maintaining and preventing deterioration of functional skills while enhancing quality of life for people with disabilities. 21st Century Assistive Technology Bill/S. 1835. Submitted letter of support to Senator Caseys office for the introduction for the 21st Century Assistive Technology Act which would help address the need for increased education of and access to the latest assistive technology devices, particularly for people with disabilities living in rural regions. United Spinal sent in comments to Rep. Suzan DelBene (D-WA) on telemedicine restrictions regarding telehealth policies in her bill entitled Mental Health Telemedicine Expansion Act/H.R. 1301 and highlighted our opposition to in-person visit requirements.

United Spinal supports S. 651/H.R 1814, the ABLE Age Adjustment Act and engaged in Hill meetings.

United Spinal supports S. 651/H.R 1814, the ABLE Age Adjustment Act.

Support H.R.1874/S. 817, ABLE Age Adjustment Act

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Continued lobby efforts on HR 620 The ADA Education and Reform Act meetings to oppose this legislation. United Spinal continues to advocate for the Disability Integration Act (S. 910, H.R. 2472). The legislation builds on the Americans with Disabilities Act and the Supreme Courts Olmstead decision, and asserts that people with disabilities have a right to live in their own homes and communities and to receive the services and supports they need to do so. United Spinal signed onto a letter of support for the Disability Integration Act (S. 910, H.R. 2472)along with numerous other disability organizations as members of the Consortium for Citizens (CCD), signed onto a letter to congressional leaders, Majority Leader McConnell and Minority Leader Schumer, Speaker Ryan and Leader Pelosi reiterating support of the Disability Integration Act (S. 910, H.R. 2472). This legislation, if passed, would ensure the rights of people with disabilities to live full and independent lives in their communities. Working with the Department of Labor in Twitter chats in promoting accessible transportation for people with disabilities. United Spinal and other stakeholder groups met with Sen. Caseys office to discuss employment challenges and opportunities for people with disabilities.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Discussed with CMS, the issue of power wheelchair standing and seat elevation devices and the need for appropriate coverage under Medicare. Discussed with CMS, the need for excluding ostomy and urology supplies from CMS' competitive bidding program. Sent letter to CMS re: the National Coverage Decision on Blood Pressure Monitoring to account for the specific needs of the SCI population. Sent letter to CMS on appropriate coding for powered orthotic and prosthetic devices for the SCI/D population. Spoke with CMS on the issue of catheter-associated UTIs and to ask CMS to look at the policy around removing indwelling catheters from individuals with SCI in a hospital setting. Removing catheters from SCI individuals is a very complex decision. Supported HR 7217 - the IMPROVE Act. Supported additional telehealth benefits in Medicare Advantage as United Spinal, and as a member of the Coalition, PCHAlliance. And provided comments to CMS on digital health and need the innovation to CMMI as part of PCHAlliance. Continued to provide comments on appropriate access to assistive technology and medical devices, as part of the ITEM Coalition on behalf of the SCI community and on appropriate rehabilitation as part of the Coalition to Preserve Rehabilitation.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Support of HR 5004 - Air Carrier Access Amendments Act of 2018 and S. 1318, ACAAA of 2017. As a member of the Air Carriers Access Act Working Group, United Spinal, along with a number of other disability organizations, signed on to a letter of support for Sections 441, 442, and 443 of the Federal Aviation Administration (FAA) Reauthorization Act of 2018 (H.R. 4).

S. 2372, VA MISSION Act: Advocated on and submitted letter of support to Senate Veterans Affairs Committee Chairman Johnny Isakson regarding this legislation. S. 2372 would combine multiple existing programs to establish a permanent Community Care Program under the Department of Veterans Affair. This program is designed to allow for timely and quality access to medical care for veterans across the nation. It would also provide clear access guidelines and quality care standards, as well as offer education programs for veterans and medical staff members regarding the program. H.R. 4146, Disabled Veterans Life Insurance Act Advocated on and submitted a letter of support to Representative Steve Pearce (R-NM) regarding this legislation. H.R. 4146 will provide congressional mandates to update mortality and annuity tables used by the VA to calculate insurance payouts for disabled veterans life insurance policies. This bill will also extend the application period from two (2) years to ten (10) years in order for all qualifying veterans to be afforded the opportunity to apply. Updating this program will allow disabled veterans to receive affordable and equitable life insurance policies that they may otherwise not qualify for in the civilian sector. H.R. 5536, Disabled Access Credit Expansion Act: Submitted a letter of support regarding this legislation. H.R. 5536 offers incentives for small businesses to comply with landmark ADA requirements resulting in expanded access and job opportunities for disabled veterans. Support of S. 2193 - Caring for our Veterans Act.

Support of HR 5004 - Air Carrier Access Amendments Act of 2018 and S. 1318, ACAAA of 2017. As a member of the Air Carriers Access Act Working Group, United Spinal, along with a number of other disability organizations, signed on to a letter of support for Sections 441, 442, and 443 of the Federal Aviation Administration (FAA) Reauthorization Act of 2018 (H.R. 4).

Continued lobby efforts on HR 620 The ADA Education and Reform Act meetings to oppose this legislation. Met with Congressional staff in the House and Senate to voice our concerns with the bill. Shared United Spinal letter of opposition on H.R. 620 the ADA Education and Reform Act via email to all House staff voicing our concerns with this legislation. United Spinal participated in NCD quarterly meeting to discuss potential new policy initiatives from autonomous vehicles to transitioning away from subminimum wage and 14(c) certificates. Attended, along with several other disability organizations, a meeting with Sen. Feinstein and Sen. Flake judiciary staffers to discuss our concerns with and opposition to H.R. 620 the ADA Education and Reform Act which was passed out of the House. H.R. 620, ADA Education and Reform Act: VetsFirst, a program of United Spinal Association, submitted a letter of opposition regarding this legislation. H.R. 620 restricts disabled patrons rights to accessible and accommodative facilities and services required by law through the Americans with Disabilities Act (ADA) by allowing businesses to delay meeting their obligations to make necessary changes to noncompliant facilities and services. United Spinal, along with numerous other disability organizations, signed on to a Consortium for Citizens with Disabilities (CCD) and the Collaboration to Promote Self Determination (CPSD) letter to express concern about the Justice Departments recent withdrawal of a number of guidance and technical assistance documents concerning the Americans with Disabilities Act (ADA). United Spinal met with Congressional staff in Rep. Langevin's office and Sen. Tammy Baldwin's office to thank them for their leadership on their bills, S, 1318 and HR 5004 and to discuss advocacy strategy together.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

S. 2372, VA MISSION Act: Advocated on and submitted letter of support to Senate Veterans Affairs Committee Chairman Johnny Isakson regarding this legislation. S. 2372 would combine multiple existing programs to establish a permanent Community Care Program under the Department of Veterans Affair. This program is designed to allow for timely and quality access to medical care for veterans across the nation. It would also provide clear access guidelines and quality care standards, as well as offer education programs for veterans and medical staff members regarding the program. H.R. 4146, Disabled Veterans Life Insurance Act Advocated on and submitted a letter of support to Representative Steve Pearce (R-NM) regarding this legislation. H.R. 4146 will provide congressional mandates to update mortality and annuity tables used by the VA to calculate insurance payouts for disabled veterans life insurance policies. This bill will also extend the application period from two (2) years to ten (10) years in order for all qualifying veterans to be afforded the opportunity to apply. Updating this program will allow disabled veterans to receive affordable and equitable life insurance policies that they may otherwise not qualify for in the civilian sector. H.R. 5536, Disabled Access Credit Expansion Act: Submitted a letter of support regarding this legislation. H.R. 5536 offers incentives for small businesses to comply with landmark ADA requirements resulting in expanded access and job opportunities for disabled veterans. Support of S. 2193 - Caring for our Veterans Act.

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Sent a letter to telehealth caucus chairs urging the passage of H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. The provisions in this bill would help to address the needs of Medicare beneficiaries in need of opioid treatment by expanding access to care using evidence-based telehealth.

Support H.R. 5609 - the Eleanor Smith Inclusive Home Design Act of 2018.

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Continued lobby efforts on HR 620 The ADA Education and Reform Act meetings to oppose this legislation. Met with Congressional staff in the House and Senate to voice our concerns with the bill. Shared United Spinal letter of opposition on H.R. 620 the ADA Education and Reform Act via email to all House staff voicing our concerns with this legislation. United Spinal participated in NCD quarterly meeting to discuss potential new policy initiatives from autonomous vehicles to transitioning away from subminimum wage and 14(c) certificates. Attended, along with several other disability organizations, a meeting with Sen. Feinstein and Sen. Flake judiciary staffers to discuss our concerns with and opposition to H.R. 620 the ADA Education and Reform Act which was passed out of the House. H.R. 620, ADA Education and Reform Act: VetsFirst, a program of United Spinal Association, submitted a letter of opposition regarding this legislation. H.R. 620 restricts disabled patrons rights to accessible and accommodative facilities and services required by law through the Americans with Disabilities Act (ADA) by allowing businesses to delay meeting their obligations to make necessary changes to noncompliant facilities and services. United Spinal, along with numerous other disability organizations, signed on to a Consortium for Citizens with Disabilities (CCD) and the Collaboration to Promote Self Determination (CPSD) letter to express concern about the Justice Departments recent withdrawal of a number of guidance and technical assistance documents concerning the Americans with Disabilities Act (ADA). United Spinal met with Congressional staff in Rep. Langevin's office and Sen. Tammy Baldwin's office to thank them for their leadership on their bills, S, 1318 and HR 5004 and to discuss advocacy strategy together.

Continued lobby efforts on HR 620 The ADA Education and Reform Act meetings to oppose this legislation. United Spinal continues to advocate for the Disability Integration Act (S. 910, H.R. 2472). The legislation builds on the Americans with Disabilities Act and the Supreme Courts Olmstead decision, and asserts that people with disabilities have a right to live in their own homes and communities and to receive the services and supports they need to do so. United Spinal signed onto a letter of support for the Disability Integration Act (S. 910, H.R. 2472)along with numerous other disability organizations as members of the Consortium for Citizens (CCD), signed onto a letter to congressional leaders, Majority Leader McConnell and Minority Leader Schumer, Speaker Ryan and Leader Pelosi reiterating support of the Disability Integration Act (S. 910, H.R. 2472). This legislation, if passed, would ensure the rights of people with disabilities to live full and independent lives in their communities. Working with the Department of Labor in Twitter chats in promoting accessible transportation for people with disabilities. United Spinal and other stakeholder groups met with Sen. Caseys office to discuss employment challenges and opportunities for people with disabilities.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Discussed with CMS, the issue of power wheelchair standing and seat elevation devices and the need for appropriate coverage under Medicare. Discussed with CMS, the need for excluding ostomy and urology supplies from CMS' competitive bidding program. Sent letter to CMS re: the National Coverage Decision on Blood Pressure Monitoring to account for the specific needs of the SCI population. Sent letter to CMS on appropriate coding for powered orthotic and prosthetic devices for the SCI/D population. Spoke with CMS on the issue of catheter-associated UTIs and to ask CMS to look at the policy around removing indwelling catheters from individuals with SCI in a hospital setting. Removing catheters from SCI individuals is a very complex decision. Supported HR 7217 - the IMPROVE Act. Supported additional telehealth benefits in Medicare Advantage as United Spinal, and as a member of the Coalition, PCHAlliance. And provided comments to CMS on digital health and need the innovation to CMMI as part of PCHAlliance. Continued to provide comments on appropriate access to assistive technology and medical devices, as part of the ITEM Coalition on behalf of the SCI community and on appropriate rehabilitation as part of the Coalition to Preserve Rehabilitation.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Discussed with CMS, the issue of power wheelchair standing and seat elevation devices and the need for appropriate coverage under Medicare. Discussed with CMS, the need for excluding ostomy and urology supplies from CMS' competitive bidding program. Sent letter to CMS re: the National Coverage Decision on Blood Pressure Monitoring to account for the specific needs of the SCI population. Sent letter to CMS on appropriate coding for powered orthotic and prosthetic devices for the SCI/D population. Spoke with CMS on the issue of catheter-associated UTIs and to ask CMS to look at the policy around removing indwelling catheters from individuals with SCI in a hospital setting. Removing catheters from SCI individuals is a very complex decision. Supported HR 7217 - the IMPROVE Act. Supported additional telehealth benefits in Medicare Advantage as United Spinal, and as a member of the Coalition, PCHAlliance. And provided comments to CMS on digital health and need the innovation to CMMI as part of PCHAlliance. Continued to provide comments on appropriate access to assistive technology and medical devices, as part of the ITEM Coalition on behalf of the SCI community and on appropriate rehabilitation as part of the Coalition to Preserve Rehabilitation.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Signed onto letter, led by the CCD Transportation Task Force, to Senator Tammy Baldwin, in support of the Air Carrier Access Amendments Act of 2017, her bill, S.1318. Congressional staff with U.S. Representative Jim Langevin's (D-RI-02) office discussed air travel for people with disabilities and related policy issues with United Spinal and other disability stakeholders. United Spinal, along with numerous disability organizations, signed on to an Air Carrier Access Act (ACAA) working group letter to the U.S. Department of Transportation expressing concern with the revised service animal policies announced by Delta Air Lines and United Airlines (United) in January. The letter read in part: We believe that these policies, which are slated to go into effect on March 1, are inconsistent with the Department of Transportations regulations implementing the Air Carrier Access Act (ACAA) (14 C.F.R 382) and the Departments Guidance Concerning Service Animals in Air Transportation, [68 Fed. Reg. 24,874 (May 9, 2003)]. Consequently, the Department must deem these revised policies to be in violation of the ACAA and advise Delta and United accordingly. United Spinal, along with numerous other disability organizations, signed on to a Consortium for Citizens with Disabilities (CCD) letter to U.S. Senator Tammy Baldwin in support of the Air Carriers Access Amendments Act of 2017 (ACAAA). Although the Air Carriers Access Act of 1986 (ACAA) prohibited discrimination based on disability in air travel and despite the ACAA has led to improved access for passengers with disabilities, significant disability-related problems persist in air travel. Travelers with disabilities still encounter damaged equipment, delayed assistance, lack of seating accommodations, and other challenges when traveling by air. Airlines reported receiving more than 30,000 passenger filed disability-related complaints in 2016. United Spinal, along with numerous other disability organizations, signed on to a Consortium for Citizens with Disabilities (CCD) letter to U.S. Senator Tammy Baldwin in support of the Air Carriers Access Amendments Act of 2017 (ACAAA). Although the Air Carriers Access Act of 1986 (ACAA) prohibited discrimination based on disability in air travel and despite the ACAA has led to improved access for passengers with disabilities, significant disability-related problems persist in air travel. Travelers with disabilities still encounter damaged equipment, delayed assistance, lack of seating accommodations, and other challenges when traveling by air. Airlines reported receiving more than 30,000 passenger filed disability-related complaints in 2016.

Support of HR 5004 - Air Carrier Access Amendments Act of 2018 and S. 1318, ACAAA of 2017. As a member of the Air Carriers Access Act Working Group, United Spinal, along with a number of other disability organizations, signed on to a letter of support for Sections 441, 442, and 443 of the Federal Aviation Administration (FAA) Reauthorization Act of 2018 (H.R. 4).

S. 2372, VA MISSION Act: Advocated on and submitted letter of support to Senate Veterans Affairs Committee Chairman Johnny Isakson regarding this legislation. S. 2372 would combine multiple existing programs to establish a permanent Community Care Program under the Department of Veterans Affair. This program is designed to allow for timely and quality access to medical care for veterans across the nation. It would also provide clear access guidelines and quality care standards, as well as offer education programs for veterans and medical staff members regarding the program. H.R. 4146, Disabled Veterans Life Insurance Act Advocated on and submitted a letter of support to Representative Steve Pearce (R-NM) regarding this legislation. H.R. 4146 will provide congressional mandates to update mortality and annuity tables used by the VA to calculate insurance payouts for disabled veterans life insurance policies. This bill will also extend the application period from two (2) years to ten (10) years in order for all qualifying veterans to be afforded the opportunity to apply. Updating this program will allow disabled veterans to receive affordable and equitable life insurance policies that they may otherwise not qualify for in the civilian sector. H.R. 5536, Disabled Access Credit Expansion Act: Submitted a letter of support regarding this legislation. H.R. 5536 offers incentives for small businesses to comply with landmark ADA requirements resulting in expanded access and job opportunities for disabled veterans. Support of S. 2193 - Caring for our Veterans Act.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

S. 2372, VA MISSION Act: Advocated on and submitted letter of support to Senate Veterans Affairs Committee Chairman Johnny Isakson regarding this legislation. S. 2372 would combine multiple existing programs to establish a permanent Community Care Program under the Department of Veterans Affair. This program is designed to allow for timely and quality access to medical care for veterans across the nation. It would also provide clear access guidelines and quality care standards, as well as offer education programs for veterans and medical staff members regarding the program. H.R. 4146, Disabled Veterans Life Insurance Act Advocated on and submitted a letter of support to Representative Steve Pearce (R-NM) regarding this legislation. H.R. 4146 will provide congressional mandates to update mortality and annuity tables used by the VA to calculate insurance payouts for disabled veterans life insurance policies. This bill will also extend the application period from two (2) years to ten (10) years in order for all qualifying veterans to be afforded the opportunity to apply. Updating this program will allow disabled veterans to receive affordable and equitable life insurance policies that they may otherwise not qualify for in the civilian sector. H.R. 5536, Disabled Access Credit Expansion Act: Submitted a letter of support regarding this legislation. H.R. 5536 offers incentives for small businesses to comply with landmark ADA requirements resulting in expanded access and job opportunities for disabled veterans. Support of S. 2193 - Caring for our Veterans Act.

Supported, advocated on READI for Disasters Act, S. 3679.

Accessible Exercise Equipment United Spinal helped introduce legislation of Senator Tammy Duckworth, S. 3729 - Exercise and Fitness For All Act that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. United Spinal Association discussed with NIH and CDC the work related to appropriating $5 million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations. Communicated with NIH the importance of focusing on the need for better outcomes data on rehab for the SCI community. United Spinal became an official non-Federal partner along with others for NIH's SCI 2020 Conference. United Spinal provided feedback on challenges and opportunities regarding improved communication and focused priorities with NIDILRR. United Spinal presented at the Spinal Cord Injury Model Systems Project Directors Meeting on the need for better rehab research outcomes for the SCI/D community.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Supports H.R. 626, the Access to Inpatient Rehabilitation Therapy Act of 2017, which would amend the Social Security Act to include recreational therapy among the therapy methods that can be considered part of an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Myomos MyoPro support letter to CMS Policy staff, as members of United Spinal Association, wrote the Centers for Medicare and Medicaid Services (CMS) in strong support of an application to CMS for a unique Healthcare Common Procedure Coding System (HCPCS) code for the MyoPro device, created by the medical technology company, Myomo. Support of S. 2227/H.R.5306 Empower Care Act which reinstates the Money Follows the Person program and facilitates smooth transitions out of nursing facilities and into the community. Signed onto letters to Congress in support of including functional quality measures in rehabilitation metrics. United Spinal supports this letter but CCD Task Force co-chairs: The co-chairs of the Consortium for Citizens with Disabilities (CCD) Health, Long-Term Services and Supports, and Rights Task Forces write in opposition to proposals that expand coverage of institutional services in Medicaid without addressing gaps in Medicaid community services. CCD is the largest coalition of national organizations working together to advocate for Federal public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society.

Supports H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act. Supports S. 486 Protecting Beneficiary Access to Complex Rehab Technology Act of 2017 Supports H.R. 3730 (To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories) was introduced by Representatives Lee Zeldin (R-NY) and John Larson (D-CT) to stop CMS from using Competitive Bid pricing for accessories used with CRT manual wheelchairs. Discussed with CMS, the issue of power wheelchair standing and seat elevation devices and the need for appropriate coverage under Medicare. Discussed with CMS, the need for excluding ostomy and urology supplies from CMS' competitive bidding program. Sent letter to CMS re: the National Coverage Decision on Blood Pressure Monitoring to account for the specific needs of the SCI population. Sent letter to CMS on appropriate coding for powered orthotic and prosthetic devices for the SCI/D population. Spoke with CMS on the issue of catheter-associated UTIs and to ask CMS to look at the policy around removing indwelling catheters from individuals with SCI in a hospital setting. Removing catheters from SCI individuals is a very complex decision. Supported HR 7217 - the IMPROVE Act. Supported additional telehealth benefits in Medicare Advantage as United Spinal, and as a member of the Coalition, PCHAlliance. And provided comments to CMS on digital health and need the innovation to CMMI as part of PCHAlliance. Continued to provide comments on appropriate access to assistive technology and medical devices, as part of the ITEM Coalition on behalf of the SCI community and on appropriate rehabilitation as part of the Coalition to Preserve Rehabilitation.

Support H.R.1874/S. 817, ABLE Age Adjustment Act

Support S. 817 the ABLE Age Adjustment Act.

Support S. 817 the ABLE Age Adjustment Act.

Continued lobby efforts on HR 620 The ADA Education and Reform Act meetings to oppose this legislation. United Spinal continues to advocate for the Disability Integration Act (S. 910, H.R. 2472). The legislation builds on the Americans with Disabilities Act and the Supreme Courts Olmstead decision, and asserts that people with disabilities have a right to live in their own homes and communities and to receive the services and supports they need to do so. United Spinal signed onto a letter of support for the Disability Integration Act (S. 910, H.R. 2472)along with numerous other disability organizations as members of the Consortium for Citizens (CCD), signed onto a letter to congressional leaders, Majority Leader McConnell and Minority Leader Schumer, Speaker Ryan and Leader Pelosi reiterating support of the Disability Integration Act (S. 910, H.R. 2472). This legislation, if passed, would ensure the rights of people with disabilities to live full and independent lives in their communities. Working with the Department of Labor in Twitter chats in promoting accessible transportation for people with disabilities. United Spinal and other stakeholder groups met with Sen. Caseys office to discuss employment challenges and opportunities for people with disabilities.

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Support H.R. 5603 the Access to Telehealth Services for Opioid Use Disorders Act. Sent a letter to ACL/HHS related to concerns about community living remarks by ACL and the disability community. Met with ACL several times to discuss community living issues including access to CRT, our support for the Disability Integration Act, S. 910/HR. 2472, competitive integrated employment and employment for people with disabilities in the healthcare sector and accessible medical diagnostic equipment. Support H.R. 6042 and HR. 5912 which amend Title XIX of the Social Security Act, to delay the reduction in Federal medical assistance percentage for Medicaid personal care services furnished without an electronic visit verification system. Accessible Exercise Equipment United Spinal helped draft and provide comments to a former Access Board member to a letter to Senator Tammy Duckworth (D-IL) urging her to introduce legislation, similar to HR 5541/S. 2888, 113th Congress - Exercise and Fitness For All Act that you co-sponsored in 2014, that would authorize the Access Board to issue guidelines specifying the number and types of accessible exercise equipment required. It also provides for a tax credit for a small business purchasing accessible exercise equipment. Medical Expense Coalition United Spinal has been advocating to increase and expand the medical expense deduction and so we signed onto a letter to Senators Susan Collins (R-ME) and Rob Portman (R-OH) who have introduced medical expense provisions in the past,as well as to the House of Representatives. For the approximately 8.8 million Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions for older Americans, children, pregnant women and other adults as well as the costs associated with long term care and assisted living. Medical expenses that qualify for this deduction can include amounts paid for prevention, diagnosis, treatment, equipment, qualified long-term care services costs as well as long term care insurance premiums. Families across the country with high health care costs face a constant stream of deductibles and high co-pays, and also pay out-of-pocket for various services and devices that enable the individual to live a productive life in the community. Opposed move of NIDILRR from ACL included in House and Senate appropriations committee language. United Spinal signed onto a Health IT Now Coalition letter to the Office of the National Coordinator for Health Information Technology and the Office of the Inspector General, both at the Department of Health and Human Services to follow up on regulatory implementation issues. Section 4004 of 21st Century Cures Act, which was signed into law in December 2016, requires the Secretary of Health and Human Services to issue regulations to prevent information blocking and to also identify reasonable and necessary activities that do not constitute information blocking. Further, the law requires the Office of the National Coordinator (ONC) to implement a standardized process for the public to submit reports on claims of health information technology products or developers of such products not being interoperable or resulting in information blocking and actions that result in information blocking. The Office of the Inspector General (OIG) has enforcement authority over vendors and providers who are found to engage in information blocking. United Spinal Association signed onto a thank you letter to Congress for appropriating $5million per year for 4 years for the National Neurological Conditions Surveillance System in 2018 appropriations.

Signed onto letters to Congress, and engaged in multiple Hill visits, opposing the ADA Education and Reform Act H.R. 620 which would create significant obstacles for people with disabilities to enforce their rights under Title III of the ADA. Title III (public accommodations) was intended to balance the interests of small businesses along with the accessibility concerns of people with disabilities. Title III does not require any action with respect to existing buildings that would cause an undue burden on businesses or that is not readily achievable. Supports S. 910/H.R. 2472 - Disability Integration Act United Spinal endorsed H.Con.Res.80 - Expressing the sense of the Congress that assisted suicide (sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases) puts everyone, including those most vulnerable, at risk of deadly harm and undermines the integrity of the health care system.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. United Spinal signed onto a letter facilitated by The National Health Council (NHC) and the National Organization for Rare Disorders (NORD) and submitted to Members of Congress. The letter, in part, reads, "The chronic and rare disease and disability patient communities rely on FDA to ensure that innovative, safe, and effective treatments reach those in need. We thank Congress for moving forward with these critical funding mechanisms, [FDA user fess] and look forward to their swift and unimpeded passage." United Spinal helped draft a Congressional statement on the issue of biopharmaceuticals to ensure consumer protections. United Spinal also submitted questions to the Congress for the nomination hearing for FDA Commissioner nominee and provided report language to the Agriculture Committee on sufficient funding needs for appropriations. United Spinal participated in this multi-coalition Hill Day, (CPR/ITEM/HAB) on June 27 to highlight to Congress the importance of rehabilitation and habilitation benefits to be included in any health reform legislation. United Spinal signed onto a letter, led by NMSS, on the need for improved patient engagement at the U.S. Food and Drug Administration. United Spinal supports robust assistive technology funding for the Assistive Technology Act Programs; protecting Medicaid funds; supporting CRT (exempting CRT power and manual chairs and components from Medicares competitive bidding program - HR 1361/S. 486); the Medicare Demonstration of Coverage for Low Vision Devices Act of 2017, H.R. 2050 and support of Steve Gleason Enduring Voices Act, H.R. 2465/S.1132 - protection of speech-generating devices under Medicare. United Spinal signed on to multiple letters to Congress in opposition to Republican efforts to reform the ACA regarding limiting pre-existing conditions, removing essential health benefits and cut Medicaid. Opposes HR. 1628, AHCA, opposes BCRA. United Spinal sent a letter to Congress joining over 80 other groups voicing our opposition to H.R. 1215 the Protecting Access to Care Act of 2017. This bill would limit the legal rights of injured patients and families of those killed by negligent health care. The bills sweeping scope covers not only cases involving medical malpractice, but also cases involving unsafe drugs and nursing home abuse and neglect.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) United Spinal wrote a letter to the VA urging for improved implementation of the Veterans Mobility Safety Act with uniform standards.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259. Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program. United Spinal and VetsFirst (a program of United Spinal Association, supports more pathways for veterans to become aviation maintenance technicians-- and expand their career opportunities. There is an FAA flight regulation (Part 147) that would be updated by a pending FAA regulation that actually updates training standards and would create a smoother pathway to expand maintenance training programs reflecting modern aircraft. H.R. 2123/S. 925, The Veterans E-Health & Telemedicine Support (VETS) Act of 2017 United Spinal, along with other disability organizations, signed onto a letter to the bipartisan leadership of Congress which introduced the Veterans E-Health & Telemedicine Support (VETS) Act of 2017 to improve the ability of veterans to access care via telehealth by relieving geographic restrictions on telehealth services and promoting access to high quality, coordinated care for all veterans, particularly those in rural areas. United Spinal is a member of the HealthIT Now Coalition which works on telemedicine initiatives at the national and state levels.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. United Spinal signed onto a letter facilitated by The National Health Council (NHC) and the National Organization for Rare Disorders (NORD) and submitted to Members of Congress. The letter, in part, reads, "The chronic and rare disease and disability patient communities rely on FDA to ensure that innovative, safe, and effective treatments reach those in need. We thank Congress for moving forward with these critical funding mechanisms, [FDA user fess] and look forward to their swift and unimpeded passage." United Spinal helped draft a Congressional statement on the issue of biopharmaceuticals to ensure consumer protections. United Spinal also submitted questions to the Congress for the nomination hearing for FDA Commissioner nominee and provided report language to the Agriculture Committee on sufficient funding needs for appropriations. United Spinal participated in this multi-coalition Hill Day, (CPR/ITEM/HAB) on June 27 to highlight to Congress the importance of rehabilitation and habilitation benefits to be included in any health reform legislation. United Spinal signed onto a letter, led by NMSS, on the need for improved patient engagement at the U.S. Food and Drug Administration. United Spinal supports robust assistive technology funding for the Assistive Technology Act Programs; protecting Medicaid funds; supporting CRT (exempting CRT power and manual chairs and components from Medicares competitive bidding program - HR 1361/S. 486); the Medicare Demonstration of Coverage for Low Vision Devices Act of 2017, H.R. 2050 and support of Steve Gleason Enduring Voices Act, H.R. 2465/S.1132 - protection of speech-generating devices under Medicare. United Spinal signed on to multiple letters to Congress in opposition to Republican efforts to reform the ACA regarding limiting pre-existing conditions, removing essential health benefits and cut Medicaid. Opposes HR. 1628, AHCA, opposes BCRA. United Spinal sent a letter to Congress joining over 80 other groups voicing our opposition to H.R. 1215 the Protecting Access to Care Act of 2017. This bill would limit the legal rights of injured patients and families of those killed by negligent health care. The bills sweeping scope covers not only cases involving medical malpractice, but also cases involving unsafe drugs and nursing home abuse and neglect.

H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act will create a separate category for CRT within the Medicare DME benefit. H.R. 1361/S486 - provides a permanent exemption from Medicare's competitive acquisition program for complex power and manual components and wheelchairs. As a member of the MapRx Coalition, United Spinal signed onto a letter to the Centers for Medicare and Medicaid Services, regarding ensuring safeguards in Medicare Part D regarding specialty tiers, protected pharmacy classes and out-of-pocket costs for beneficiaries. United Spinal wrote a letter to the Centers for Medicare and Medicaid Services (CMS) urging for separate coding options for titanium materials (makes for lighter wheelchairs/easier maneuverability) for wheelchairs if it is the beneficiarys choice. CMS issued a recent policy determination not allowing wheelchair providers to bill the beneficiary for titanium. United Spinal policy staff convened a meeting with senior personnel at CMS, along with PVA, National Multiple Sclerosis Society, Christopher and Dana Reeve Foundation and ITEM Coalition to discuss expanded access to CRT under Medicare; the seat elevation feature (which is not covered by Medicare), and titanium wheelchairs. Met with other personnel at CMS to discuss future delays of the competitive bidding program. United Spinal submitted a letter to CMS urging for discrete coding for hydrophilic (lubricated) catheters. United Spinal opposes any provision that expands the Medicaid Secondary Payer statute to allow for the Agency to collect funds from a judgment or settlement beyond what was provided for medical care is unfair and harmful to Medicaid beneficiaries and has submitted a letter to House and Senate. United Spinal supports S. 253/H.R. 807 - Medicare Access to Rehabilitation Services Act, which would protect Medicare beneficiaries from arbitrary limits on outpatient physical therapy, occupational therapy, and speech-language pathology services that are often needed to recover from debilitating illnesses, such as stroke, or support the effective management of conditions including SCI, multiple sclerosis and arthritis. Sent letter of support for the HR 2465/S 1132 Steve Gleason Enduring Voices Act of 2017 to revise the Steve Gleason Act of 2015 (114th Congress S. 984). United Spinal signed onto a similar letter, facilitated by the Center for Medicare Advocacy. The Steve Gleason Enduring Voices Act will remove the sunset date, currently identified in law as October 1, 2018. We seek this revision to prevent extremely vulnerable Medicare beneficiaries from ever again having to relinquish their only means of communication. By revising the Steve Gleason Act of 2015 to remove the sunset date, beneficiaries with ALS, MS, Parkinsons disease, paralysis, cerebral palsy and other debilitating conditions will be assured that Medicare coverage for speech generating devices (SGD) and related accessories will continue to be available.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed disability community concerns around improving accessibility. Non-Emergency Medical Transportation - opposed HR 1394 which amends Title XIX of the Social Security Act to provide States with flexibility with respect to providing coverage for non-emergency transportation under Medicaid. Support safety measures and facilitate policies regarding the development of autonomous vehicles for people with disabilities.

Discussed disability community concerns around improving accessibility. Non-Emergency Medical Transportation - opposed HR 1394 which amends Title XIX of the Social Security Act to provide States with flexibility with respect to providing coverage for non-emergency transportation under Medicaid. Support safety measures and facilitate policies regarding the development of autonomous vehicles for people with disabilities.

Discussed disability community concerns around improving accessibility. Non-Emergency Medical Transportation - opposed HR 1394 which amends Title XIX of the Social Security Act to provide States with flexibility with respect to providing coverage for non-emergency transportation under Medicaid. Support safety measures and facilitate policies regarding the development of autonomous vehicles for people with disabilities.

Discussed disability community concerns around improving accessibility. Non-Emergency Medical Transportation - opposed HR 1394 which amends Title XIX of the Social Security Act to provide States with flexibility with respect to providing coverage for non-emergency transportation under Medicaid. Support safety measures and facilitate policies regarding the development of autonomous vehicles for people with disabilities.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259 Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program (VRE) Support H.R. 1618, the Support our Services (S.O.S.) to Veterans Caregivers Act.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. United Spinal signed onto a letter facilitated by The National Health Council (NHC) and the National Organization for Rare Disorders (NORD) and submitted to Members of Congress. The letter, in part, reads, "The chronic and rare disease and disability patient communities rely on FDA to ensure that innovative, safe, and effective treatments reach those in need. We thank Congress for moving forward with these critical funding mechanisms, [FDA user fess] and look forward to their swift and unimpeded passage." United Spinal helped draft a Congressional statement on the issue of biopharmaceuticals to ensure consumer protections. United Spinal also submitted questions to the Congress for the nomination hearing for FDA Commissioner nominee and provided report language to the Agriculture Committee on sufficient funding needs for appropriations. United Spinal participated in this multi-coalition Hill Day, (CPR/ITEM/HAB) on June 27 to highlight to Congress the importance of rehabilitation and habilitation benefits to be included in any health reform legislation. United Spinal signed onto a letter, led by NMSS, on the need for improved patient engagement at the U.S. Food and Drug Administration. United Spinal supports robust assistive technology funding for the Assistive Technology Act Programs; protecting Medicaid funds; supporting CRT (exempting CRT power and manual chairs and components from Medicares competitive bidding program - HR 1361/S. 486); the Medicare Demonstration of Coverage for Low Vision Devices Act of 2017, H.R. 2050 and support of Steve Gleason Enduring Voices Act, H.R. 2465/S.1132 - protection of speech-generating devices under Medicare. United Spinal signed on to multiple letters to Congress in opposition to Republican efforts to reform the ACA regarding limiting pre-existing conditions, removing essential health benefits and cut Medicaid. Opposes HR. 1628, AHCA, opposes BCRA. United Spinal sent a letter to Congress joining over 80 other groups voicing our opposition to H.R. 1215 the Protecting Access to Care Act of 2017. This bill would limit the legal rights of injured patients and families of those killed by negligent health care. The bills sweeping scope covers not only cases involving medical malpractice, but also cases involving unsafe drugs and nursing home abuse and neglect.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Signed on to letter of support for the Stop Taxing Death and Disability Act of 2017. H.R. 1659/S. 405 Discussed the importance of direct mail in providing funding to non-profits and opposing restrictions on individual charitable giving.

Signed on to letter of support for the Stop Taxing Death and Disability Act of 2017. H.R. 1659/S. 405 Discussed the importance of direct mail in providing funding to non-profits and opposing restrictions on individual charitable giving.

Signed on to letter of support for the Stop Taxing Death and Disability Act of 2017. H.R. 1659/S. 405 Discussed the importance of direct mail in providing funding to non-profits and opposing restrictions on individual charitable giving.

Signed on to letter of support for the Stop Taxing Death and Disability Act of 2017. H.R. 1659/S. 405 Discussed the importance of direct mail in providing funding to non-profits and opposing restrictions on individual charitable giving.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. United Spinal signed onto a letter facilitated by The National Health Council (NHC) and the National Organization for Rare Disorders (NORD) and submitted to Members of Congress. The letter, in part, reads, "The chronic and rare disease and disability patient communities rely on FDA to ensure that innovative, safe, and effective treatments reach those in need. We thank Congress for moving forward with these critical funding mechanisms, [FDA user fess] and look forward to their swift and unimpeded passage." United Spinal helped draft a Congressional statement on the issue of biopharmaceuticals to ensure consumer protections. United Spinal also submitted questions to the Congress for the nomination hearing for FDA Commissioner nominee and provided report language to the Agriculture Committee on sufficient funding needs for appropriations. United Spinal participated in this multi-coalition Hill Day, (CPR/ITEM/HAB) on June 27 to highlight to Congress the importance of rehabilitation and habilitation benefits to be included in any health reform legislation. United Spinal signed onto a letter, led by NMSS, on the need for improved patient engagement at the U.S. Food and Drug Administration. United Spinal supports robust assistive technology funding for the Assistive Technology Act Programs; protecting Medicaid funds; supporting CRT (exempting CRT power and manual chairs and components from Medicares competitive bidding program - HR 1361/S. 486); the Medicare Demonstration of Coverage for Low Vision Devices Act of 2017, H.R. 2050 and support of Steve Gleason Enduring Voices Act, H.R. 2465/S.1132 - protection of speech-generating devices under Medicare. United Spinal signed on to multiple letters to Congress in opposition to Republican efforts to reform the ACA regarding limiting pre-existing conditions, removing essential health benefits and cut Medicaid. Opposes HR. 1628, AHCA, opposes BCRA. United Spinal sent a letter to Congress joining over 80 other groups voicing our opposition to H.R. 1215 the Protecting Access to Care Act of 2017. This bill would limit the legal rights of injured patients and families of those killed by negligent health care. The bills sweeping scope covers not only cases involving medical malpractice, but also cases involving unsafe drugs and nursing home abuse and neglect.

H.R. 2123/S. 925, The Veterans E-Health & Telemedicine Support (VETS) Act of 2017 United Spinal, along with other disability organizations, signed onto a letter to the bipartisan leadership of Congress which introduced the Veterans E-Health & Telemedicine Support (VETS) Act of 2017 to improve the ability of veterans to access care via telehealth by relieving geographic restrictions on telehealth services and promoting access to high quality, coordinated care for all veterans, particularly those in rural areas. United Spinal is a member of the HealthIT Now Coalition which works on telemedicine initiatives at the national and state levels. Proposed Rule, Prosthetic and Rehabilitative Items and Services: This proposed rule would strike and replace Title 38, CFR 17.150, and update 17.3200-3250, by addressing vague and subjectively interpreted language regarding the feasibility and medical need of certain medical equipment and services for disabled veterans, as well as update the currently limited list of such services and items. Submitted comments regarding our support for efforts to improve current policy and benefit disabled veterans. S. 1318, Air Carrier Access Amendments Act: This bill is to amend Title 49 of U.S.C., Section 41705, by addressing the needs of disabled Americans, including veterans, traveling by air, including needed safety training for TSA staff and flight attendants, reasonable accommodations for Americans with spinal cord injuries and/or disease, and accessibility issues throughout the airline industry for such Americans. United Spinal's VetsFirst program sent a letter to the House Veterans Affairs Subcommittee on Economic Opportunity opposing proposed legislation which is designed to diminish the current approved and valuable training and education track for veterans. It would "liquidate" the GI bill and push veterans to end their benefit in 18 months, thus discouraging selection of aviation education programs at approved public universities. United Spinal's VetsFirst program sent a letter of support to Congresswoman Dina Titus (D-NV) specifically in support of her bill HR 3197, which puts an end to research practices at the Department of Veterans Affairs which do not lead to any positive outcomes for veterans. United Spinal's VetsFirst program signed onto a letter in support of S.1318, the Aircraft Carrier Access Amendments Act, and S.1405, the Federal Aviation Administration Reauthorization Act, which are both designed to expand access measures for disabled aircraft passengers, as well as training requirements for aircraft and TSA personnel in handling disabled passengers and their equipment. United Spinal co-wrote a letter to the Senate stating objections to amendments added to the National Defense Authorization Act bill on the Senate floor that would harm vital defense health research programs specifically initiated to help US soldiers who sustain traumatic brain (TBI) and spinal cord injuries (SCI). The letter was sent to the Senate Armed Services Committee.

Support VA Accountability Legislation to Enable VA Leaders to Manage Workforce Issues Effectively to Improve Healthcare Access for Veterans - HR 1259. Enhance Department of Veterans Affairs Vocational Rehabilitation and Employment Benefits Program. United Spinal and VetsFirst (a program of United Spinal Association, supports more pathways for veterans to become aviation maintenance technicians-- and expand their career opportunities. There is an FAA flight regulation (Part 147) that would be updated by a pending FAA regulation that actually updates training standards and would create a smoother pathway to expand maintenance training programs reflecting modern aircraft. H.R. 2123/S. 925, The Veterans E-Health & Telemedicine Support (VETS) Act of 2017 United Spinal, along with other disability organizations, signed onto a letter to the bipartisan leadership of Congress which introduced the Veterans E-Health & Telemedicine Support (VETS) Act of 2017 to improve the ability of veterans to access care via telehealth by relieving geographic restrictions on telehealth services and promoting access to high quality, coordinated care for all veterans, particularly those in rural areas. United Spinal is a member of the HealthIT Now Coalition which works on telemedicine initiatives at the national and state levels.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. United Spinal signed onto a letter facilitated by The National Health Council (NHC) and the National Organization for Rare Disorders (NORD) and submitted to Members of Congress. The letter, in part, reads, "The chronic and rare disease and disability patient communities rely on FDA to ensure that innovative, safe, and effective treatments reach those in need. We thank Congress for moving forward with these critical funding mechanisms, [FDA user fess] and look forward to their swift and unimpeded passage." United Spinal helped draft a Congressional statement on the issue of biopharmaceuticals to ensure consumer protections. United Spinal also submitted questions to the Congress for the nomination hearing for FDA Commissioner nominee and provided report language to the Agriculture Committee on sufficient funding needs for appropriations. United Spinal participated in this multi-coalition Hill Day, (CPR/ITEM/HAB) on June 27 to highlight to Congress the importance of rehabilitation and habilitation benefits to be included in any health reform legislation. United Spinal signed onto a letter, led by NMSS, on the need for improved patient engagement at the U.S. Food and Drug Administration. United Spinal supports robust assistive technology funding for the Assistive Technology Act Programs; protecting Medicaid funds; supporting CRT (exempting CRT power and manual chairs and components from Medicares competitive bidding program - HR 1361/S. 486); the Medicare Demonstration of Coverage for Low Vision Devices Act of 2017, H.R. 2050 and support of Steve Gleason Enduring Voices Act, H.R. 2465/S.1132 - protection of speech-generating devices under Medicare. United Spinal signed on to multiple letters to Congress in opposition to Republican efforts to reform the ACA regarding limiting pre-existing conditions, removing essential health benefits and cut Medicaid. Opposes HR. 1628, AHCA, opposes BCRA. United Spinal sent a letter to Congress joining over 80 other groups voicing our opposition to H.R. 1215 the Protecting Access to Care Act of 2017. This bill would limit the legal rights of injured patients and families of those killed by negligent health care. The bills sweeping scope covers not only cases involving medical malpractice, but also cases involving unsafe drugs and nursing home abuse and neglect.

Signed onto letters to Congress, and engaged in multiple Hill visits, opposing the ADA Education and Reform Act H.R. 620 which would create significant obstacles for people with disabilities to enforce their rights under Title III of the ADA. Title III (public accommodations) was intended to balance the interests of small businesses along with the accessibility concerns of people with disabilities. Title III does not require any action with respect to existing buildings that would cause an undue burden on businesses or that is not readily achievable. Supports S. 910/H.R. 2472 - Disability Integration Act United Spinal endorsed H.Con.Res.80 - Expressing the sense of the Congress that assisted suicide (sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases) puts everyone, including those most vulnerable, at risk of deadly harm and undermines the integrity of the health care system.

Signed onto letter to Congress, and engaged in multiple Hill visits, opposing the ADA Education and Reform Act H.R. 620 which would create significant obstacles for people with disabilities to enforce their rights under Title III of the ADA. Title III (public accommodations) was intended to balance the interests of small businesses along with the accessibility concerns of people with disabilities. Title III does not require any action with respect to existing buildings that would cause an undue burden on businesses or that is not readily achievable. Supports S. 910/H.R. 2472 - Disability Integration Act

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

Discussed options for United Spinal to be a potential grantee of the agencys Paralysis Resource Center. The PRC provides comprehensive information for people living with spinal cord injury, paralysis and mobility-related disabilities and their families. Resources include information and referral by phone and email in multiple languages including English and Spanish; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; free lending library; quality of life grants; and a national website. The grant components and requirements may differ in upcoming grant announcements. Opposed efforts to repeal and replace the Affordable Care Act with multiple letters to White House and to the Hill as well as Hill meetings and signed onto letters in support of protection of pre-existing conditions and essential health benefits. Support HR 750 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017 Support HR 1361/S. 486 - to protect access to complex rehab wheelchairs and essential components required by people with disabilities Support implementing what was passed into law as part of the 21st Century Cures Act - HR 292/S. 849 including ensuring robust funding. Support HR 807 and S. 253 - Medicare Access to Rehabilitation Services Act of 2017. Raised concerns with HR 1628- The American Health Care Act Provided comments to NIDILRR on their long-range plan regarding government-wide research to include adaptive fitness and nutrition. Continue to discuss NIH government research on disability and rehabilitation issues.

H.R. 750 The Ensuring Access to Quality Complex Rehabilitation Technology (CRT) Act will create a separate category for CRT within the Medicare DME benefit. H.R. 3730 - provides a permanent exemption from Medicare's competitive acquisition program for manual CRT and wheelchairs and related components(including endorsing a letter to Congress). United Spinal Association signed onto a letter to CMS spearheaded by Consumer Voice opposing a nursing home rule on pre-dispute arbitration agreements. The existing regulation is designed to ensure that a resident enters into an arbitration agreement only if he or she knows what is at stake and has made a conscious decision to choose arbitration. The proposed regulation, on the other hand, would lead to the routine use and enforcement of pre-dispute binding arbitration agreements that were signed when the resident knew nothing of the dispute that ultimately is arbitrated, and signed only because the resident had to agree to arbitration in order to be admitted. Nursing facilities would quickly institute policies requiring pre-dispute binding arbitration agreements from all incoming residents. CONGRESSIONAL AND CMS SUPPORT LETTERS United Spinal Association supports the Benefits Improvement and Protection Act (BIPA), (including Section 427) which urges CMS to ensure that Medicare beneficiaries continue to have access to quality prosthetic and custom-fabricated orthotic care provided by practitioners and suppliers with appropriate education, training and experience. Supports H.R. 3635 which is companion legislation to S. 794 which 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. Signed onto a letter to HR 3178, the Medicare Part B Improvement Act: bill contains provisions addressing beneficiary access to care, including prosthetic & orthotics, home infusion, and ESRD issues. United Spinal Association, as part of the Coalition to Preserve Rehabilitation, shared concerns with Congress on limiting caps on therapy services and reviewing issues around pre- and post-payment review and complications of complex patients. Also opposed, as part of this coalition the Graham Cassidy proposal to repeal the ACA. Also submitted comments on this: (CMS-1672-P) Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and Proposed CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Raised concerns related to Jimmo, therapy thresholds and billing timeframes.