Policy
Round-Up: Input needed on Medicare wheelchair coverage;
new MFP states, CMS guidance on behavioral health for
children, and more
By Vicki Gottlich,
Director - Center for Policy and Evaluation
In this Policy Round-Up:
·
Input Needed: Medicare
coverage of wheelchair seat elevation systems (Due Sept.15)
·
Five new states/territories
join CMS’ Money Follows the Person program
·
New CMS guidance:
Strengthening Behavioral Health Care for Children
·
New HUD Funding to Expand
Access to Affordable, Accessible Housing
·
CMS Simplifies Claims for
Medicare Durable Medical Equipment
·
ICYMI: NIDILRR Final Rule
Input Needed: Medicare
coverage of wheelchair seat elevation systems (Due Sept.15)
The Centers for Medicare
& Medicaid Services (CMS) has accepted a formal request
to review their coverage criteria for seat elevation
systems on certain power wheelchairs. These systems raise
and lower users while they remain in the seated position,
providing varying amounts of vertical height. They
currently are not covered by Medicare because CMS has not
determined that their use is primarily medical in nature.
CMS is soliciting public comment and is specifically
interested in scientific literature that provides evidence
of “the medical necessity of seat elevation systems by
studying the measurable characteristics related to the
performance of transfers.”
We urge the aging and disability network to weigh in and
provide comment. Comments
close September 15, 2022.
Note: CMS was asked look at both seat elevation and
standing systems; CMS decided to review them separately and
will be returning to standing systems in a different
coverage determination.
Five new
states/territories join CMS’ Money Follows the Person
program
CMS recently awarded approximately $25
million in
planning grants to five new states and territories to
expand access to home and community-based services (HCBS)
through Medicaid’s Money
Follows the Person (MFP) demonstration program. With these
grants, Illinois, Kansas, and New Hampshire, as well as
for American Samoa and Puerto Rico will now participate
in the program, bringing the total number of participating
states and territories to 41.
The MFP program provides enhanced
federal funding for services to people move from nursing
homes or other institutions to homes in the community. The
program has helped facilitate more than 107,000 transitions
out of institutional settings since 2008. Thanks in part to
programs like MFP, more than 85% of people who used
Medicaid long-term services and supports in 2019 received
HCBS rather than institutional services.
New
CMS guidance: Strengthening Behavioral Health Care for
Children
As part of the national strategy to
address the country’s mental health crisis, CMS has issued
guidance to states detailing strategies to expand mental
health care for children. These focus on the urgent
behavioral health needs among kids and youth; more than 40 percent of high school
students report struggling with persistent
feelings of sadness or hopelessness, and more than half of parents and
caregivers are concerned about the mental
well-being of their children. These include:
·
A bulletin reminding
states of their responsibilities under the Medicaid
Early and Periodic, Screening, Diagnostic and Treatment
(EPSDT) benefit, including the mandate to provide mental
health care . The guidance provides strategies states can
adopt, as well as specific examples of how states have
effectively used Medicaid, CHIP and other federal programs
to provide mental health services and supports to children
and youth.
·
A bulletin prompting state Medicaid
agencies to work with schools to deliver on-site
health care services, including mental health care, to
children enrolled in the Medicaid program. Medicaid covers
many services that may be provided through schools,
including immunizations, health screenings, oral health
care, substance use disorder treatment, and mental health
care. Providing these services in schools allows providers
to reach children and youth where they are to get them the
care they need.
New
HUD Funding to Expand Access to Affordable, Accessible
Housing
To ensure people with disabilities can find affordable,
accessible housing in the community the U.S. Department of
Housing and Urban Development recently awarded more than $36 million
for Mainstream Vouchers and associated administrative fees
to 218 public housing agencies (PHA) in 46 states.
The Mainstream Voucher program is
a subset of HUD’s Housing Choice Voucher program,
which helps older adults, people with disabilities, and
very low-income families afford decent, safe and clean
housing in the private market. The Mainstream Voucher
program is specifically focused on non-elderly people with
disabilities. The Mainstream Voucher program specifically
assists people with disabilities, including those
transitioning to the community from institutional settings.
Through the program, local public health agencies
coordinate with centers for independent living, state
protection and advocacy systems, Medicaid agencies, HUD’s Continuums of Care , and
to provide referrals, housing search assistance, and
coordination of supportive services.
HUD’s funding award includes:
·
$23 million for 2,391 new
Mainstream Vouchers that public housing agencies and
disability networks and services partners can use to help
people with disabilities transition from (or avoid)
institutional settings to homes in the community or to help
them avoid or exit homelessness.
·
$13 million in additional
administrative fees that help PHAs and their partners
support tenants’ housing search and navigation, fund
landlord engagement activities, and cover other move-in
costs.
Read more
HUD also announced $2.8 billion in competitive funding
to homeless services organizations across the country for
supportive services and housing programs for people
experiencing homelessness. The funding will be awarded
through the Continuum of Care program, the largest source
of federal grant funding for homeless services and housing
providers. The announcement contains $52 million in funding
explicitly for new rapid re-housing, supportive services,
and other activities critical to assist survivors of
domestic violence, dating violence, sexual assault, or
stalking. Additionally, approximately $80 million is
available for non-competitive Youth Homelessness Demonstration
Program (YHDP) renewal and replacement expiring
grants to support youth experiencing homelessness.
Specifically, HUD is seeking applicants that place emphasis
on racial equity and anti-discrimination polices for LGTBQ+
individuals, engage people with lived experience of
homelessness in decision-making and partner with health
agencies to coordinate health and supportive services,
among others.
Homelessness among
older adults is increasing, and people
with disabilities are more likely than their non-disabled
peers to experience homelessness. This
significant increase in funding will provide critical
support to the aging and disability community.
CMS
Simplifies Claims for Medicare Durable Medical Equipment
As part of its ongoing efforts to increase access to care
and to reduce unnecessary administrative burden for
stakeholders, the Centers for Medicare & Medicaid
Services will be discontinuing the use of Certificates of
Medical Necessity and Durable Medical Equipment Information
Forms for claims with dates of service on or after January
1, 2023. This will make it easier for providers and
suppliers to get beneficaries the Durable Medical Equipment
they need. For more information, see the CMS Medicare Learning Network article.
ICYMI:
NIDILRR Final Rule
ACL has published a final rule governing
research funded by its National Institute on Disability,
Independent Living, and Rehabilitation Research
(NIDILRR). The rule includes two
significant changes. First, it revises the criteria used to
evaluate applications for funding to allow NIDILRR to
better evaluate – and consider -- the extent to which grant
applicants encourage applications for employment from
people with disabilities and people from other groups that
traditionally have been underserved and underrepresented.
The second change will enable reviewers to evaluate the
extent to which applicants are proposing appropriate
engineering knowledge and methods as part of their
applications for funding through the Rehabilitation Engineering Research
Centers (RERC) program.
These regulatory changes further NIDILRR’s long-standing
efforts to advance equity and increase the representation
of people with disabilities within the research teams
NIDILRR funds.
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