ARN Health Policy Digest – March 2023

We are pleased to present the February issue of the ARN Health Policy Digest. This member benefit provides updates on health policy and legislative and regulatory developments that may be of interest to rehabilitation nurses.

President Biden Releases FY 2024 Budget Request

On March 9, the Biden Administration released its Fiscal Year (FY) 2024 budget request, which includes $144 billion for the Department of Health and Human Services (HHS), an 11.5% increase from its enacted level for FY 2023. The budget proposal, which outlines the President's policy priorities and funding goals for the upcoming fiscal year, signals the official start of the FY 2024 appropriations process. It should be noted that the request does not have the force of law, and none of these policies will be enacted unless adopted by Congress. Congressional committees will now hold hearings on the President's Budget, and the House and Senate Appropriations Committees will consider their FY 2024 appropriations bills over the next few months.

In the meantime, let's take a look at the President's proposed funding levels for health programs of interest to ARN members:

• $349.9 million for the Title VIII Nursing Workforce Development Programs, which is an increase of $49.5 million over the FY 2023 enacted levels. The President's budget specifies $32 million to expand, enhance, and modernize nursing education programs, as well as $17 million for Advanced Nursing Education to grow and diversify the maternal and perinatal health nursing workforce.
• $198 million in flat funding for the National Institute of Nursing Research (NINR)
• $119 million in flat funding for the Administration for Community Living (ACL) National Institute on Disability, Independent Living, and Rehabilitation Research
• $1.352 billion for the Centers for Disease Control and Prevention (CDC) Center for Injury Prevention and Control, which is an increase of over $500 million over FY 2023 enacted levels.

Senate HELP Committee Issues RFI to Address Healthcare Workforce Shortages​

The Senate Health, Education, Labor and Pensions (HELP) Committee issued a request for information (RFI) seeking comments from stakeholders on health care workforce shortages and potential legislative solutions. ARN submitted joint comments with the American Medical Rehabilitation Providers Association (AMPRA) with recommendations to support the nursing workforce: (1) supporting a rehabilitation nursing curriculum to drive more entry into the field and increase awareness of the field's needs; (2) removing unnecessary and time-intensive clinical reporting requirements to alleviate provider burnout and improve retention of specialized rehabilitation nurses and other skilled staff; and (3) taking further action to prevent workplace violence in our rehabilitation hospitals.

 CMS Proposed Rule to Improve Prior Authorizations Processes​

ARN was pleased to provide comments on the Centers for Medicare & Medicaid Services (CMS)proposed rule that would improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services. As outlined in our comment letter, which is available here, we provided recommendations on methods for better care coordination and specific timeframes and communication requirements for payers. We also recommended that CMS work to implement these improvements in the prior authorization process for prescription drugs. ARN looks forward to working with CMS to ensure access to quality care for Medicare beneficiaries with physical disabilities and/or chronic disease.

CMS Proposed Coverage for Seat Elevation Systems​

On February 15, CMS released a proposed National Coverage Determination (NCD) decision that would, for the first time, expand coverage for power seat elevation equipment on certain power wheelchairs to Medicare individuals. If finalized, power seat elevation equipment would be covered by Medicare for individuals with a Group 3 power wheelchair under this NCD. ARN submitted comments on the proposed NCD highlighting our support for this proposal and the benefits of seat elevation in the disability community. We also recommended that CMS extend coverage to improve reach & line of sight to support shoulder, upper spine, and neck integrity, and support coverage for seat elevation for users of Group 2 wheelchairs with the minimum height for the seat elevation system of at least 6 inches.

 Notices and Funding Opportunities

• Request for Information: Re-envisioning U.S. Postdoctoral Research Training and Career Progression within the Biomedical Research Enterprise (NOT-OD-23-084) Comments due: April 14
• Request for Information on the NIH Plan to Enhance Public Access to the Results of NIH-Supported Research (NOT-OD-23-091) Comments due: April 24
  Nurse Education, Practice, Quality and Retention (NEPQR)-Pathway to Registered Nurse Program (PRNP) (HRSA-23-016) Deadline: April 27
• Department of Health and Human Services Administration for Community Living Rehabilitation Research and Training Center (RRTC) on Employment Among People with Physical Disabilities Synopsis 1 Deadline: May 8
• Advancing Integrated Models (AIM) of Care to Improve Pregnancy Outcomes among Women Who Experience Persistent Disparities (R01 Clinical Trial Optional) Deadline: May 1
• Evaluating the Impact of Pandemic Era related Food and Housing Policies and Programs on Health Outcomes in Health Disparity Populations (R01 Clinical Trial Optional) Deadline: May 1
• Clinical-Community Linkages to Address Social Needs and Social Conditions to Advance Health Equity among Populations Experiencing Health Disparities: The Bridge-to-Care Initiative (R01 Clinical Trial Required) Deadline: May 1