NDRN believes individuals with disabilities have the equal right to access high-quality, affordable healthcare that meets the specific needs of the individual and includes mental health services. To achieve these goals, the Network's efforts at the state and local level include individual casework and community training programs. At the national level NDRN advocates for public policies that support access to quality health care and services for individuals with disabilities.
In order to ensure that the Medicare program provides individuals with disabilities of all ages access to the health care services they need, Congress should:
- Enact legislation to ensure that drug plans participating in the Medicare prescription drug program are required to have drug formularies that meet the needs of individuals with disabilities. This should include formulary exceptions, emergency dosing, and expedited appeals.
- Amend the Medicare Modernization Act to ensure that individuals with disabilities can easily appeal decisions and access hearings in their communities.
- Enact legislation that removes the two-year Medicare waiting period for individuals with disabilities, and revise the in-the-home definition to ensure access to needed durable medical equipment and assistive technology in the least-restrictive setting.
As the largest funding source for health and long-term supports in the federal system, Medicaid continues to be a lifeline for millions of children and adults with disabilities and their families. While some important improvements are needed such as removing the institutional bias the Medicaid program has successfully provided health care and long-term supports to low-income individuals and people with disabilities for over 40 years.
For Medicaid reform to be responsive to the needs of beneficiaries with disabilities, Congress must take the following actions to restore protections and funding for Medicaid beneficiaries:
- Roll back changes made to the Medicaid program in the Deficit Reduction Act (DRA).
- Maintain the individual entitlement to a full range of Medicaid health and long-term supports and services for all children and adults with disabilities no matter how they access Medicaid by ensuring they are not limited to services in "benchmark" plans. This includes continued access to needed mandatory and optional Medicaid benefits.
- Restore the entitlement to seamless delivery of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, and reject the bifurcated system established by the budget reconciliation process.
- Repeal federal policy that increases recipient cost-sharing through co-payments and premiums.
- Repeal legislative language that prohibits individuals with disabilities who live in provider -owned or -operated housing from participating in "Cash and Counseling" and other consumer-directed programs.
- Repeal federal policy that gives states the option of putting a capped program within a Medicaid State Plan, and pass legislation such as the Medicaid Community-based Attendant Services and Support Act to reduce institutionalization and increase home- and community-based long-term services and supports.
- Direct the Centers for Medicare and Medicaid Services (CMS) to cease making regulatory and policy changes detrimental to individuals with disabilities, such as reduced access to habitation, targeted case management, and school-based services.
- Strengthen the Medicaid Waiver and Medicaid State Plan processes by requiring states to establish public notification, opportunity for comment, and reporting mechanisms for applications for proposed waivers and state plan changes.
- Require CMS to hold states accountable for the quality of supports and services provided to individuals in all settings.
- Require CMS to issue guidance to states that leads to the expanded coverage of appropriate assistive technology for Medicaid beneficiaries.
- Ensure that any changes based upon the Medicaid Commission's recommendations for long-term reform of the Medicaid program increase the quality of life of individuals with disabilities.
- Monitor implementation of recent federal policy changes to assure that individuals with disabilities are not negatively affected.
- Oppose Medicaid block grants, global or per capita caps, or any other mechanisms that lead to reductions in eligibility, supports and services, and protections for individuals with disabilities.
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