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Budget/Appropriations
According to lead House appropriations staff, work continues behind the scenes on compromise spending legislation but its final form remains unclear---omnibus (combining all appropriations bills into one), minibus (combining all appropriations bills into several small packages), or full year CR. Republican leaders favor a "minibus" strategy of coupling the remaining 11 appropriations bills together and moving each package separately. Speaker Paul Ryan (R-WI) believes this is the only way to get spending bills through the House, as conservative Members in the Republican caucus are do not favor one large omnibus bill.
Health Care
Medicare MARCA Final Rule
On Friday, the Centers for Medicare and Medicaid (CMS) published the Final Rule to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which replaces the Sustainable Growth Rate (SGR) for physician reimbursement. This final rule marks one of the biggest changes in Medicare since its creation. According to CMS, this rule aims to create a more modern, patient-centered program by promoting quality patient care while controlling costs. Though there are supporters and critics of the final rule, HHS stated the rule is informed by a months-long listening tour with nearly 100,000 attendees and 4,000 public comments. Eligible clinicians will be able to choose from two tracks 1) the Alternative Payment Model in which they would be willing to accept financial risk and reward for performance, report quality measures, and use electronic medical records; or 2) the Merit-Based Incentive Payment System (MIPS) which features more modest financial risks and rewards, and accountability for quality, efficiency, use of electronic medical records and self-improvement. Physicians can opt out of the MIPS track if they participate in an alternative payment model (such as Accountable Care Organization or patient-centered medical home); those that do choose this path can earn annual bonuses of 5%, and will also be exempt from the MIPS reporting measures. Outside of these two options, about 380,000 clinicians are expected to be exempt from the new systems because they do not see a significant number of Medicare patients. See Executive Summary on the CMS.gov website form more details.
Open Letter to Presidential Candidates
AUCD signed onto an Open Letter developed by the Partnership to Improve Patient Care (PIPC) with over 50 other groups representing a diverse group of patients and participants in the health system. The open letter calls on the Presidential candidates and debate moderators discuss plans for ensuring that our health care system is person-centered and rewards outcomes.
Programs of All-Inclusive Care for the Elderly (PACE) Proposed Rule
The Consortium for Citizens with Disabilities (CCD) LTSS Task Force, of which AUCD is a member, submitted recommendations for the proposed PACE regulation specifically focused on the application of the home and community-based services (HCBS) settings requirement. CCD strongly supports the application of the settings rule to PACE. The settings requirements set standards to ensure that Medicaid community-based services are non-institutional in nature; these are requirements that are entirely appropriate for PACE services. PACE services often are provided at a specific PACE center, but the availability of services at the center should not isolate consumers from the broader community. We suggest that the proposed amendment incorporate the settings requirement beyond its current sections to also include subsections that sets standards and describes settings.
Electrical Devices
In June, AUCD signed onto a letter with several other national organizations urging the FDA to finalize the ban on electrical devices used for behavior control and not extend the comment period beyond its original date. These devices present an unreasonable and substantial risk of illness or injury that cannot be corrected or eliminated by labeling. Despite having already had multiple public comment periods, spending years gathering evidence, and holding hearings, FDA allowed an extension of the comment period on the rule from a deadline of May 25 to July 25, 2016. Though the extended comment period closed almost three months ago, no final Rule has been issued. CCD leaders have requested a meeting with the U.S. HHS Secretary Sylvia Burwell.
Housing
On October 14, the CCD Housing Task Force sent a letter to Principal Deputy Assistant Secretary Castro Ramirez urging that HUD act quickly to issue a Notice to implement the tenant selection preferences authorized under Section 106 of Housing Opportunities Through Modernization Act of 2016 (HOTMA). This letter addresses the HOTMA provisions that pertain to creating supportive housing for persons with disabilities (PWD) through the Project Based Voucher (PBV) program. The CCD Housing Task Force is particularly interested in prompt implementation of these provisions due to our longstanding goal to expand affordable, accessible housing for PWD with the lowest incomes, including integrated permanent supportive housing for people who are chronically homeless, institutionalized, or most at-risk of these conditions.
National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)
NIDILRR will host several listening sessions across the country to help inform future funding priorities and strategic direction. Public meetings will be held October 14 and 28, November 1 and 18, and December 5. Attendees should come prepared to answer the following questions: 1) What issues (barriers) make it challenging for you to be an active member of your community? 2) What improvements (name the top one or two) would make your daily life better? 3) What has changed, for better or worse, in the last five years that has affected your ability to achieve your goals? Registration information is available on the Administration for Community Living's website. Written comments may also be submitted via email to [email protected].
Disability Positions of the Presidential Candidates
See comparisons of U.S. presidential candidate's position on disability related issues provided by the American Association of People with Disabilities, Respectability, and Complex Child,
Upcoming Events
Tuesdays with Liz: Disability Policy for All
During this week's edition of Tuesdays with Liz, Liz interviews Bruce Darling (Community Organizer for ADAPT) about the Disability Integration Act. In case you missed the last two editions, Liz interviewed Jennifer Mathis (Director of Policy and Legal Advocacy at the Bazelon Center for Mental Health Law) in a two-part series on mental health and the connection to people with disabilities - part one, part two.
For more from AUCD, follow @AUCDNews and like AUCD on Facebook
For updates from our Executive Director Andy Imparato, follow @AndyAUCD.
For more policy news, follow Kim on Twitter at @kmusheno
For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms
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