Policy Round-Up: Input needed on Medicare wheelchair coverage; new MFP states, CMS guidance on behavioral health for children, and more

September 9, 2022
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.


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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 beneficiaries 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.
 


Last modified on 09/09/2022


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