Key message is: clinicians should update prescriptions now to ensure continued access to the hydrophilic catheters they prescribe and avoid disruptions when new billing codes take effect on January 1, 2026.

Beginning on January 1, 2026, the Centers for Medicare and Medicaid Services (CMS) will introduce new HCPCS billing codes specific to hydrophilic catheters. For many years, hydrophilic and non-hydrophilic catheters shared the same codes. This update better reflects hydrophilic technology, but it also means that prescriptions must be written differently going forward.

What clinicians need to know:

1. New prescriptions: Write “hydrophilic” or include the brand name/item number. Do not include HCPCS codes.
2. Renewal prescriptions: Expect updated scripts from suppliers. Review carefully, confirm “hydrophilic” or brand name/item number is included, and remove HCPCS codes.
3. Updating prescriptions this way ensures they are valid in 2025 and with the new billing codes starting on January 1, 2026.
    

To make it easy for you to communicate this change, we created a brand-agnostic toolkit with ready-to-use materials you can share with your members:

1. Newsletter/letter copy
2. Blog article
3. Short blog/newsletter version
4. Two email templates (initial announcement + reminder)
5. Four social media posts
    

We encourage you to share these resources, and act now. Early updates protect clinicians’ prescribing decisions, prevent delays, and ensure patients stay on the catheter they were prescribed.
Full deatils here >>

Centers for Medicare and Medicaid Services (“CMS”) issued the CY 2026 Home Health and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program final last Friday, November 28th. The ITEM Coalition is deeply disappointment that CMS seemingly ignored the concerns shared by the disability community and decided to move forward and finalize provisions in the rule that exposes Medicare patients to the lowest bidder for ostomy and urological supplies, as well as certain orthotic braces, under the Medicare program. To make matters worse, CMS accelerated the timeline and some of the changes go into effect as early as next year.

The ITEM Coalition is examining all available options to address our concerns, and will continue our efforts to help ensure access and preserve the diversity of products, suppliers, and clinically appropriate options required to meet the specific medical needs of all Medicare beneficiaries, particularly beneficiaries with disabilities. In the meantime, we implore CMS to immediately pause implementation of this flawed policy and work collaboratively with the disability, patient, and clinical communities to ensure beneficiary access remains the highest priority.
Please find attached an ITEM Coalition press release here >>

A link to the text is available here: https://public-inspection.federalregister.gov/2025-21767.pdf

For the corresponding CMS Fact Sheet, click here: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-final-rule-cms-1828-f

To access the DMEPOS CBP Fact Sheet, click here: https://www.cms.gov/newsroom/fact-sheets/durable-medical-equipment-prosthetics-orthotics-supplies-competitive-bidding-program-updates

As you have likely seen, yesterday the House of Representatives passed (222-209)—and the President signed into law last night—a continuing resolution (“CR”) to fund the federal government and resume normal operations through January 30, 2026. With this action, federal departments and programs that were affected by the record-breaking 43-day shutdown will begin the process of reopening and restoring activities over the coming days.

The CR includes three full-year funding bills (through September 30, 2026, rather than January) collectively called a “minibus.” One bill funds the Department of Agriculture, including full funding for the Supplemental Nutrition Assistance Program (“SNAP”), while another funds military construction and the Department of Veterans Affairs. Another facet of the “minibus” allows for salaries and allowances to go toward the legislative branch.

More importantly, the end of the government shutdown allows furloughed federal workers to return to work and back pay to go to both furloughed workers and those who continued working through the shutdown. The deal also reverses the Trump Administration’s layoffs during the shutdown and prohibits federal funds from being “used to initiate, carry out, implement, or otherwise notice a reduction in force to reduce the number of employees within any department, agency, or office of the Federal Government” until January 30, 2026. This layoff freeze temporarily protects the federal workers who were terminated at the U.S. Department of Education, thereby allowing disabled students and their families continued support and federal civil rights protections, such as those under the Individuals with Disabilities Education Act (“IDEA”).

Additional provisions were included in the CR that are of potential interest to ITEM Members, including:

• Sec. 6208. Extension of certain telehealth flexibilities. This section extends Medicare telehealth flexibilities that were extended in the Consolidated Appropriations Act, 2023, through January 30, 2026, but retroactive to October 1st.

• Sec. 6213. Medicare Sequestration. This section extends by one month the mandatory 2% Medicare sequestration payment reductions as a pay-for.

• Sec. 8001. Budgetary Effects. This section prevents/waives the 4% Statutory PAYGO sequestration cuts to Medicare, agriculture, and other programs, which would have gone into effect January 1, 2026.

Additional guidance from CMS is forthcoming with respect to the provisions included in the CR, including the telehealth flexibility extension. However, all of the telehealth flexibilities that were available prior to October 1st are reinstated through the end of January 2026 and retroactive to October 1, 2025.

We will continue to monitor any impacts or delays as agencies return to full operations and will keep you informed of any relevant updates impacting the ITEM Coalition’s advocacy priorities.

A link to the final LCD is available here:  LCD - Urological Supplies (L33803)

A link to the related Policy Article is available here:  Article - Urological Supplies - Policy Article (A52521)

For CMS’s response to the comments received, please click here:  Article - Response to Comments: Urological Supplies - DL33803 (A60353)

We are pleased to report that the long-awaited Local Coverage Determination (“LCD”) for Urological Supplies has been published, and the ITEM Coalition is very pleased with the results. The ITEM Coalition submitted comments in support of the proposed LCD on October 10th, and we are thrilled to see that the Durable Medical Equipment Medicare Administrative Contractors (“DME MAC”) Medical Directors finalized the addition of the new hydrophilic urinary catheter codes and, as proposed, added spinal cord injury (“SCI”) at any level to qualify for access to sterile catheter kits, which help reduce dangerous urinary tract infections.

More importantly, we are pleased that the DME MACs have also clarified in the policy article that “For intermittent catheterization using a sterile intermittent catheter kit (A4297, A4353), documentation in the medical record of a diagnosis of SCI is sufficient to establish that the beneficiary is immunocompromised” (emphasis added), which is one of the key criteria for Medicare coverage of sterile catheter kits. The effective date for these changes is January 1, 2026.

The ITEM Coalition applauds the DME MACs for finalizing these important changes to the Urological Supplies LCD, and we greatly appreciate the DME MACs for expanding coverage of sterile catheter kits to include immunosuppressed beneficiaries with SCI at any level. These finalized changes represent a critically important step toward aligning policy with both clinical evidence and patient need. The clinical literature clearly demonstrates the high correlation between sustaining an SCI and resulting immunosuppression. We believe this should be the standard for coverage, i.e., that every beneficiary with SCI should be considered immunosuppressed and eligible for sterile catheter kits.

In our comments, the ITEM Coalition urged the DME MACs to go even further in the final LCD or subsequent LCDs to expand coverage of sterile catheter kits to individuals living with neurogenic bladder disorder due to congenital and non-congenital conditions. However, CMS did not address neurogenic bladder in the final LCD because it was “outside the scope” of the proposed LCD. This will continue to be a goal of the ITEM Coalition for future consideration. Regardless, this final LCD represents a significant victory for the disability community as this coverage expansion promotes equitable access to essential urological care, reduces preventable complications, and ensures that patients receive treatment consistent with current clinical standards of practice.

Description Today, the Trump Administration announced a landmark decision to expand coverage of anti-obesity medications (“AOMs”) for the treatment of obesity under the Medicare and Medicaid programs. This decision marks a tremendous victory not only for the disability community at large, but for the ITEM Coalition membership as well, which has prioritized support for this coverage expansion since it was originally proposed in November 2024 by the Biden Administration.

By expanding coverage of anti-obesity medications under the Medicare and Medicaid programs, the Administration is advancing the principles of independence and function that are central to the ITEM Coalition’s mission. As the ITEM Coalition has consistently emphasized, coverage of anti-obesity medications is not simply about managing weight—it is about restoring function and enabling individuals, especially in the disability community, to live full and independent lives.

While final details of the policy’s implementation are forthcoming, this coverage expansion is a major step forward and we are thrilled with this significant and positive development.

Please find attached a formal ITEM Coalition press release announcing this major coverage policy change for your records.
Full details here >>

ITEM Coalition letter to the leadership of the House and Senate Committees of jurisdiction urging Congress to continue working with the Centers for Medicare and Medicaid Services (CMS) to enable Medicare beneficiaries living with disabilities and chronic obesity to access AOMs through the Medicare Part D program
Full details here >>

ACRM Signed on to ITEM Coalition letter to the leadership of the House and Senate Committees of jurisdiction urging Congress to continue working with the Centers for Medicare and Medicaid Services (CMS) to enable Medicare beneficiaries living with disabilities and chronic obesity to access AOMs through the Medicare Part D program.
Full details here >>

Please find attached two, identical ITEM Coalition letters of support for H.R.4475/S. 2329, the Medicare Orthotics and Prosthetics (“O&P) Patient-Centered Care Act. One letter will go to the original House sponsors and the other letter will go to the original Senate sponsors thanking them for their leadership in reintroducing this important bill in the 119th Congress. Because this is the same bill from the 118th Congress, which the ITEM Coalition fully supported and endorsed, we have decided to make this an opt-out sign-on opportunity for ITEM Coalition member’s consideration.
ITEM Coalition Draft Letter >>
ITEM Coalition Final Letter >>

Under the Social Security Act, Medicare covers diabetic shoes when prescribed and furnished by a podiatrist (or other qualified physician), provided the managing MD or DO certifies the patient’s eligibility and medical need. However, overly burdensome compliance requirements imposed by the DME MACs have significantly reduced beneficiary access to this critical benefit, leaving patients at increased risk for diabetic foot complications, including ulceration, infection, and amputation. These outcomes not only raise the cost of care but also increase patient morbidity and mortality
Full details here >>

ACRM Signed on to an ITEM Coalition comment letter in support of a recently proposed Local Coverage Determination (“LCD”) on urological supplies (DL33803). Under the proposal, CMS would expand Medicare coverage of sterile intermittent catheter kits for individuals with a spinal cord injury (“SCI”) regardless of the level of injury. The letter expresses the ITEM Coalition’s strong support for this proposed coverage expansion and urges the Durable Medical Equipment Medicare Administrative Contractors (“DME MACs”) to go even further in the final LCD or in future LCDs to consider evidence demonstrating that coverage should be expanded to all individuals with neurogenic bladder regardless of etiology, including congenital conditions.
Full details here >>

As ITEM Coalition Members:

The ITEM Coalition has prepared a grassroots messaging campaign for you to distribute to your respective memberships urging them to contact their Members of Congress to encourage them to sign-on to the Dunn/Murphy letter to the Trump Administration.

Your members can access and send this email in under two minutes using the following link: https://powerslaw.quorum.us/campaign/143586/

Full details here >>

Full details here >>

Full details here >>

Please join us on Monday, August 11th, from 2:00-3:00pm ET for an ITEM Coalition educational webinar entitled, Competitive Bidding and Patient Harm: Why Ostomy and Urological Supplies Must Be Exempt.

During this free one-hour webinar, you will learn more about the arguments for why CMS should not move forward with a proposal that was included in the CY 2026 Home Health proposed rule to include ostomy and urological supplies in the next round of Medicare competitive bidding—a move that is contrary to Congressional intent and threatens to undermine patient choice, access and quality for individuals with bowel and bladder management issues who require daily use of ostomy and urological supplies. This includes individuals with paralysis, spina bifida, stroke, and a wide range of other disabling conditions.

Panelists for the webinar include:

Peter W. Thomas, J.D., ITEM Coalition Co-Coordinator
Michael Barnett, J.D., ITEM Coalition Co-Coordinator
Julie Allen, J.D, Principal, Powers Law Firm
Leela Baggett, J.D., Principal, Powers Law Firm
TBD: Other speakers with expertise on ostomy and urological care
Full details available here >>

DRRC issued a statement, developed with the steering committee, on the reductions in force (RIFs) at the Department of Health & Human Services (HHS), impacting thousands of employees, after a Supreme Court decision allowing the RIFs proposed earlier this year by the Trump Administration to proceed. See statement here >>

ACL and NIDILLR-supporting staff were seriously impacted with whole offices left completely without staff. We fear that, without an alternative plan of action by ACL/HHS, these empty positions are likely to slow or even stop the flow of grant dollars for certain programs. Here’s an article providing more details on HHS wide layoffs: HHS finalizes 'portion' of layoffs after Supreme Court ruling. More details available here >>

Announcing the reintroduction of H.R. 4475/S. 2329, the Medicare Orthotics and Prosthetics (“O&P”) Patient-Centered Care Act. This transformative legislation has been endorsed by the ITEM Coalition in previous Congresses, and we are pleased to again be supportive in the 119th Congress. This bipartisan and bicameral bill reflects a strong, united commitment to improving access to high-quality orthotic and prosthetic care for individuals with limb loss and limb impairment while protecting the Medicare program from waste, fraud, and abuse. Full details available here >>

The briefing will be held in-person on Monday, July 21st at 1:30pm ET at the Rayburn House Office Building (Room 2060). We wanted to pass this information along to ensure ITEM members were aware and to encourage those who are able to attend and show support. (ACRM is not aware of a option to attend virtually) Full details available here >>

The bill was a bipartisan and bicameral bill in the 118th Congress that would ensure Medicare beneficiaries can access the orthotics and prosthetics devices they need. Under current Medicare requirements, beneficiaries are at risk of receiving orthotic and prosthetic devices without the necessary services and customization required for the best use. The bill will clarify the law and permit Medicare beneficiaries who require prosthetics and orthotics to receive these important services.
The bill is expected to be reintroduced next week on Wednesday, July 17, 2025, by Reps. Glenn “GT” Thompson (R-PA), Mike Thompson (D-CA), Gus Bilirakis (R-FL), and Debbie Dingell (D-MI). GT Thompson’s office is preparing a press release and has asked if the organizations on record in support of the bill during the 118th Congress continue to support the bill. Full details available here >>

ACRM signed-on in support of an ITEM Coalition letter to the Centers for Medicare and Medicaid Services (“CMS”) encouraging the agency to initiate future rulemaking to create and establish a timelier and more predictable pathway for Medicare coverage of Food and Drug Administration (“FDA”)-designated breakthrough medical technologies. Specifically, the letter urges CMS to move forward with a much more robust and streamlined coverage pathway—similar to the Medicare Coverage of Innovative Technology (“MCIT”) framework—providing time-limited Medicare coverage for FDA-designated breakthrough technologies upon a determination that they are safe and effective.

This type of policy, which the ITEM Coalition has endorsed previously, is aligned with the legislative language included in S. 1717, the Ensuring Patient Access to Critical Breakthrough Products Act of 2025, that is currently being considered in the 119th Congress. Such a policy would remove unnecessary regulatory barriers and accelerate patient access to critical innovations—supporting clinicians in delivering the best possible care and helping improve health outcomes for millions of individuals with disabilities, functional limitations, and chronic conditions. Full details available here >>

The letter specifically urges CMS to direct the Durable Medical Equipment Medicare Administrative Contractors (“DME MACs”) to remove language in Local Coverage Article (“LCA”) A52504 indicating that Medicare does not cover power standing features to remove barriers for claim-by-claim consideration of Medicare coverage of power standing systems for Medicare beneficiaries for whom these systems are medically necessary. The letter also urges the agency again to move forward with opening the long-pending National Coverage Analysis (“NCA”) for power standing systems as soon as possible. Full details available here >>

These centers, which are administered by the Administration for Community Living (“ACL”), fulfill critical needs for a large swath of ITEM Coalition constituencies by providing free, comprehensive information, peer support, and navigational assistance that empower Americans living with limb loss, limb difference, or paralysis to live independently and fully participate in their communities. The letter urges Congressional leadership to not move forward with the proposal to eliminate funding for these critical programs and to appropriate continued, sustained, and robust funding for both centers Full details available here >>

These centers, which are administered by the Administration for Community Living (“ACL”), fulfill critical needs for a large swath of ITEM Coalition constituencies by providing free, comprehensive information, peer support, and navigational assistance that empower Americans living with limb loss, limb difference, or paralysis to live independently and fully participate in their communities. The letter urges Congressional leadership to not move forward with the proposal to eliminate funding for these critical programs and to appropriate continued, sustained, and robust funding for both centers Full details available here >>

The FINAL letter to The Honorable Mehmet OZ, MD Administrator Centers for Medicare and Medicaid Services (“CMS”) requesting a meeting to discuss the status of the long-pending National Coverage Analysis (“NCA”) for standing systems in Group 3 power wheelchairs has been submitted. Full details available here >>

ITEM Coalition SIGN On to Letter regarding a Meeting Request with the Honorable Mehmet Oz, MD Administrator for CMS to Discuss Pending National Coverage Analysis for Standing Systems in Power Wheelchairs Full details available here >>

FINAL letter of support for H.R. 3417, the Websites and Software Applications Accessibility Act, was officially submitted to Rep. Pete Sessions’ (R-TX) office this afternoon, June 13, 2025 Full details here >>

This bill, which was recently reintroduced in the 119th Congress by Rep. Pete Sessions (R-TX), would require that websites and applications used by covered entities (employment entities, public entities, public accommodation, or testing entities) to communicate or interact with applicants, employees, participants, customers, or other members of the public be readily accessible to and useable by individuals with disabilities. The ITEM Coalition supported this bill in the 118th Congress Full details here >>

There is no fee for participation in this webinar, but we do ask that you please register beforehand to ensure you receive the proper webinar link. A registration link is available here >>

Full details available here >>

The ITEM Coalition letter to Congressional leadership highlighting the critical need to protect Medicaid beneficiaries’ access to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) was submitted this morning Full details available here >>

Disability community letter to CMS Administrator, Dr. Mehmet Oz, regarding the recent unfortunate decision not to finalize the proposed expanded coverage for anti-obesity medications (“AOMs”) that was included in the CY 2026 Medicare Advantage and Medicare Part D Prescription Drug Benefit Programs proposed rule. Full details available here >>

CPR & ITEM Coalition Sign On to a disability community letter to CMS Administrator, Dr. Mehmet Oz, regarding the recent unfortunate decision not to finalize the proposed expanded coverage for anti-obesity medications (“AOMs”) that was included in the CY 2026 Medicare Advantage and Medicare Part D Prescription Drug Benefit Programs proposed rule Full details available here >>

ACRM endorses the ITEM Coalition’s proposed Mobility Means Freedom Tax Credit Act of 2025 (H.R. 2320), which offers a 50% tax credit to individuals purchasing qualified mobility devices for themselves, a spouse, or a dependent. The credit offsets high out-of-pocket costs for essential equipment like wheelchairs, prosthetics, and orthotics—helping individuals live more independently. Though especially beneficial for Medicare beneficiaries, it applies broadly. Aligned with the ITEM Coalition’s expanded mission to promote access to assistive technology, ACRM views this legislation as a constructive step toward improving mobility, autonomy, and quality of life. Full details available here >>

The Centers for Medicare and Medicaid Services (“CMS”) issued the CY 2026 MA and Medicare Part D final rule this past Friday afternoon and decided not to move forward with finalizing the proposed coverage expansion for anti-obesity medications (“AOMs”) at this time. The ITEM Coalition submitted extensive comments in support of this proposed coverage decision back in January, so we wanted to ensure ITEM members were aware of this development. While we are ultimately disappointed with the Trump Administration’s decision, we remain encouraged by the prospects for inclusion in future rulemaking and will continue to urge the agency to revisit this issue through the lens of the disability community and to address the intersect between disability and obesity in any future rulemaking as soon as possible. Full details available here >>

Please find attached an ITEM Coalition letter of support for H.R. 2005, the DMEPOS Relief Act of 2025, which was recently reintroduced by Rep. Mariannette Miller-Meeks (R-IA), for your review and sign-on consideration. H.R. 2005 would provide critically-needed funding relief to many home medical equipment (“HME”) providers across the country and ensure continued access to these essential medical supplies for seniors and individuals with disabilities. More specifically, the bill would re-establish the 75/25 blended Medicare reimbursement rate for DMEPOS in non-rural/non-Competitive Bidding Areas through the end of 2025. This 75/25 blended rate expired on January 1, 2024, and was a much-needed lifeline for DMEPOS suppliers and providers and afforded beneficiaries continued access to the level of care and services that they needed. Full details available here >>

An ITEM Coalition letter of support for H.R. 2005, the DMEPOS Relief Act of 2025, which was recently reintroduced by Rep. Mariannette Miller-Meeks (R-IA), for your review and sign-on consideration. H.R. 2005 would provide critically-needed funding relief to many home medical equipment (“HME”) providers across the country and ensure continued access to these essential medical supplies for seniors and individuals with disabilities. More specifically, the bill would re-establish the 75/25 blended Medicare reimbursement rate for DMEPOS in non-rural/non-Competitive Bidding Areas through the end of 2025. This 75/25 blended rate expired on January 1, 2024, and was a much-needed lifeline for DMEPOS suppliers and providers and afforded beneficiaries continued access to the level of care and services that they needed. Full details available here >>

Last week, Paralyzed Veterans of America (“PVA”) filed a motion with the U.S. Court of Appeals for the Fifth Circuit for leave to intervene in Airlines for America et al. v. U.S. Department of Transportation, a legal challenge brought by major U.S. airlines against a landmark Department of Transportation (“DOT”) rule that enhances safety and dignity for air travelers with disabilities. A "motion for leave to intervene" is a formal request by a third party (in this case, PVA) to join an ongoing lawsuit or legal proceeding, arguing that they have a significant interest in the outcome and should be allowed to participate. The regulation at the center of the case is the Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs final rule, which was issued in December 2024 following years of advocacy from disability rights organizations, including the ITEM Coalition. The rule sets vital boarding assistance standards, mandates airline personnel training, and provides compensation and rebooking protections for passengers whose wheelchairs or scooters are damaged or mishandled during air travel. The motion was filed by PVA due to broad concern from disability advocates that the airline industry threatens hard-won protections for a population that faces disproportionate risks during air travel. Full details available here >>

Disability community letter in support of the proposed coverage expansion of anti-obesity medications (“AOMs”) for the treatment of obesity under the Medicare and Medicaid programs that was included in the CY 2026 Medicare Advantage and Medicare Part D proposed rule last year. Full details available here >>

Full details available here >>

We are pleased to inform you that the ITEM Coalition’s letter in support of Mary Ann Clark’s nomination to serve on the Medicare Evidence Development & Coverage Analysis Committee (“MEDCAC”) as an industry representative has been submitted Full details available here >>

ACRM supports key ITEM (Independence Through Enhancement of Medicare and Medicaid) Coalition 2025 policy priorities, including improving Medicare coverage for wheelchairs, low vision aids, new technologies, and expanding rehabilitation services. They advocate for timely service and repairs, access to titanium and carbon fiber wheelchairs, and maintaining Essential Health Benefits. Efforts also address DMEPOS coverage, orthotics and prosthetics policies, and accessible medical diagnostic equipment. They engage with Congress to push for policy advancements and transparency. Full details available here >>

Final CPR letter of support to Senate leadership urging for swift passage of the Senate’s FY 2026 Labor-HHS-Education Appropriations package was successfully submitted to Senate leadership offices December 19, 2025
Full details here >>

CPR letter of support to Senate leadership urging them to bring to the floor and pass the bipartisan federal fiscal year (“FY”) 2026 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations package. As many of you may be aware, the Senate’s FY 2026 Labor-HHS Appropriations bill provides stable—and in several cases strengthened—funding for programs that support rehabilitation and disability research, workforce development, patient protection, and community living.

In contrast, the House FY 2026 proposal would make significant cuts to core disability, rehabilitation, public health, and aging programs at a time when demand for these services continues to grow. The letter notes that the Senate Labor-HHS bill offers a bipartisan, responsible path forward that protects vulnerable populations and maintains national commitments to rehabilitation access, scientific advancement, and disability rights, and it encourages Senate leadership to expeditiously pass the Senate’s version of the bill and include it in the anticipated upcoming federal funding package.

Full details here >>

CPR letter of concern to the Department of Veterans’ Affairs (“VA”) regarding its decisions to: (1) discontinue the use of CARF International (“CARF”) accreditation for Veterans Health Administration (“VHA”) rehabilitation programs; and (2) terminate the uSPEQ veteran experience survey within CARF-accredited VHA rehabilitation programs.

The letter specifically urges the VA to immediately reinstate both CARF accreditation and the uSPEQ survey system. Restoring these accreditation services would reaffirm the VA’s longstanding commitment to transparency, accountability, and continuous improvement in the care of our nation’s heroes. CPR firmly believes that veterans deserve a rehabilitation system grounded in independent evaluation, evidence-based standards, and, above all, respect for the veteran’s voice.
Full details here >>

CPR letter of concern to the Department of Veterans’ Affairs (“VA”) regarding its decisions to: (1) discontinue the use of CARF International (“CARF”) accreditation for Veterans Health Administration (“VHA”) rehabilitation programs; and (2) terminate the uSPEQ veteran experience survey within CARF-accredited VHA rehabilitation programs was submitted to the VA this morning.
Full details here >>

CPR Members:

As you have likely seen, yesterday the House of Representatives passed (222-209)—and the President signed into law last night—a continuing resolution (“CR”) to fund the federal government and resume normal operations through January 30, 2026. With this action, federal departments and programs that were affected by the record-breaking 43-day shutdown will begin the process of reopening and restoring activities over the coming days.

The CR includes three full-year funding bills (through September 30, 2026, rather than January) collectively called a “minibus.” One bill funds the Department of Agriculture, including full funding for the Supplemental Nutrition Assistance Program (“SNAP”), while another funds military construction and the Department of Veterans Affairs. Another facet of the “minibus” allows for salaries and allowances to go toward the legislative branch.

More importantly, the end of the government shutdown allows furloughed federal workers to return to work and back pay to go to both furloughed workers and those who continued working through the shutdown. The deal also reverses the Trump Administration’s layoffs during the shutdown and prohibits federal funds from being “used to initiate, carry out, implement, or otherwise notice a reduction in force to reduce the number of employees within any department, agency, or office of the Federal Government” until January 30, 2026. This layoff freeze temporarily protects the federal workers who were terminated at the U.S. Department of Education, thereby allowing disabled students and their families continued support and federal civil rights protections, such as those under the Individuals with Disabilities Education Act (“IDEA”).

Additional provisions were included in the CR that are of interest to CPR, including:

• Sec. 6208. Extension of certain telehealth flexibilities. This section extends Medicare telehealth flexibilities that were extended in the Consolidated Appropriations Act, 2023, through January 30, 2026, but retroactive to October 1st.
• Sec. 6213. Medicare Sequestration. This section extends by one month the mandatory 2% Medicare sequestration payment reductions as a pay-for.
• Sec. 8001. Budgetary Effects. This section prevents/waives the 4% Statutory PAYGO sequestration cuts to Medicare, agriculture, and other programs, which would have gone into effect January 1, 2026.

Additional guidance from CMS is forthcoming with respect to the provisions included in the CR, including the telehealth flexibility extension. However, all of the telehealth flexibilities that were available prior to October 1st are reinstated through the end of January 2026 and retroactive to October 1, 2025.

We will continue to monitor any impacts or delays as agencies return to full operations and will keep you informed of any relevant updates impacting CPR’s advocacy priorities.

A link to a section-by-section summary of the CR is available here >>

CPR letter of support for S. 2898, the Dennis John Benigno Traumatic Brain Injury (“TBI”) Program Reauthorization Act of 2025. Introduced on October 8th, this important, bipartisan legislation represents a timely and critical opportunity to reauthorize and strengthen the federal programs that support individuals and families affected by TBI. This letter will be sent to the original Senate sponsors of the bill thanking them for their leadership in sponsoring this important legislation, which will ensure access to the continuum of rehabilitative care and community-based services that brain injury survivors and their families need to recover, improve function, and achieve as much independence and the highest quality of life possible
Full details here >>

CPR comment letter (draft) in response to the CY 2026 Medicare Physician Fee Schedule Proposed Rule. CPR focuses its comments on three specific provisions in the rule. First, we offer comments on the proposed CY 2026 Physician Fee Schedule payment update and conversion factor. The second area we focus on in our comments relates to preserving access to rehabilitation through accurate service valuation. Lastly, we focus on the treatment of telehealth and telerehabilitation going forward as the federal government continues to consider how to maintain access to these services on a permanent basis. Full details here >>

The WISeR Model introduces to the Medicare fee-for-service program a technology-driven, artificial intelligence-fueled, model to review the medical necessity of certain services. It relies on a financially-incentivized prior authorization and pre-payment review framework—much like the Recovery Audit Contractor (“RAC”) program—for select items and services furnished under traditional Medicare in six states (NJ, OH, OK, TX, AZ and WA).

The program takes the form of a five-year demonstration project but the impact of the program is much more pervasive and, potentially, permanent.

The attached letter stresses to CMS that while CPR fully supports efforts to reduce waste, fraud, and abuse in the Medicare program, we are deeply troubled by the potential unintended consequences of the WISeR Model and curbing access to medically necessary medical rehabilitation and therapy services for beneficiaries with disabilities and other chronic conditions.
Read full details here >>

This bipartisan and bicameral bill, which CPR has strongly supported in the previous two Congresses, was recently reintroduced in the 119th Congress and it would reform the use of prior authorization in the Medicare Advantage (“MA”) program. More specifically, the bill would help protect patients, including those in need of rehabilitation care, from unnecessary delays in care due to overuse and misuse of prior authorization in MA. The bill would also streamline and standardize the use of prior authorization in many situations and provide much-needed transparency for rehabilitation patients in the MA program, all of which CPR supports. Full details available here >>

ACRM Signed on to the Final letter from CPR and HAB (Habilitation Benefits Coalition) CPR/HAB Coalition letter to Senate leadership in response to the Senate Finance Committee’s draft reconciliation package was submitted to Capitol Hill yesterday afternoon Full details available here >>

Given the nature and magnitude of the impact of the Medicaid proposals on individuals with disabilities and chronic conditions, we feel it is imperative for our coalitions to respond expeditiously. While the letter maintains a respectful tone, it firmly expresses our opposition to these proposals at a broad level and clearly outlines the reasons for our concerns. Full details available here >>

The Improving Seniors’ Timely Access to Care Act is slated for introduction tomorrow, May 20th, 2025, by U.S. Senators Roger Marshall, M.D. (R-KS) and Mark Warner (D-VA), and U.S. Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Ami Bera, M.D. (D-CA), and John Joyce, M.D. (R-PA). We are thrilled that the bill already has 71 endorsing organizations, 23 Senate cosponsors, and 34 House cosponsors. Full details available here >>

CPR letter to the new CMS Administrator, Dr. Mehmet Oz, welcoming him to his new role and requesting a meeting to discuss how CMS and CPR can work together going forward to ensure that Medicare and Medicaid beneficiaries Full details available here >>

FY 2026 IRF PPS Proposed Rule – Key Updates for Members : CMS proposes a 2.8% payment increase for Inpatient Rehabilitation Facilities (IRFs) in FY 2026, totaling $295 million, based on a 3.4% market basket update minus a 0.8% productivity cut. The rule removes 2 COVID-19 vaccine measures and 4 Social Determinants of Health (SDOH) items from the IRF Quality Reporting Program (QRP). The outlier threshold drops from $12,043 to $11,971. Data submission deadlines would shorten to 45 days. CMS seeks feedback on digital measurement, interoperability, nutrition, and delirium. Public comments are due by June 7, 2025. Full details available here >>

Friday, April 11th, the Centers for Medicare and Medicaid Services (“CMS”) released the federal Fiscal Year (“FY”) 2026 Inpatient Rehabilitation Facility Prospective Payment System (“IRF PPS”) Proposed Rule (CMS-1829-P) for public inspection. The proposed rule is relatively straightforward and short this year (only 95 pages total). Overall, the proposed rule would provide a modest 2.8% payment increase for IRFs in FY 2026. For the QRP, CMS proposed to remove two measures related to COVID-19 vaccination requirements beginning with the FY 2026 (CY 2024) and FY 2028 (CY 2026) IRF QRP, respectively. CMS is also proposing to remove four social determinants of health (“SDOH”) patient assessment data elements to reduce burden beginning October 1, 2025. The agency is also proposing to amend its reconsideration policy and process on which IRFs can appeal IRF QRP payment penalties and also includes four separate RFIs on the IRF QRP in general. Full details available here >>

We wanted to pass along an article that was published this morning by CBS News on physical therapy cap limits and the impact that the caps have had on patients in need of rehabilitation care. Two CPR members (the Falling Forward Foundation and the Academy of Physical Medicine & Rehabilitation) are mentioned in the article, and we are pleased that it has finally been published. With national coverage like this, even more people across the country will have a better understanding of this important issue and we wanted to share it with the CPR membership to ensure you were aware.

A link to the story is available here: Their physical therapy coverage ran out before they could walk again - CBS News

We wanted to pass along a short 15-minute podcast that the American Medical Association (AMA) published this morning on the impact of therapy caps on rehabilitation therapy services. The podcast is very well done and features CPR steering committee member, Sam Porritt with the Falling Forward Foundation, as well as Dr. Atul Patel who is a member of the American Academy of Physical Medicine & Rehabilitation, which is also a CPR member. A link to the podcast is available here >>

ACRM supports key CPR (Coalition to Preserve Rehabilitation) 2025 policy priorities to reform Medicare post-acute care, ensure access to medical rehabilitation, and expand telehealth services. The advocacy efforts extend to preserving Essential Health Benefits, upholding Affordable Care Act protections, increasing awareness and access for Long COVID patients to post-COVID-19 rehabilitation, and responding to regulations that impact rehabilitation services. High-level strategies include engaging with Congress, promoting patient education, and ensuring transparency in healthcare processes. Full details available here >>

At 1:00 PM today, DRRC sent our letter to Senate leadership and the Appropriations Committee in support of the Senate L-HHS bill. This letter reinforces the message DRRC has consistently conveyed to Congress throughout the year advocating for full funding of critical disability and rehabilitation research programs.
Full details here >>

The Senate is currently reviewing several full-year funding bills to pass as a “minibus,” including its version of the Labor-HHS appropriations bill for fiscal year (FY) 2026. After consulting with the Steering Committee, DRRC has decided to endorse the Senate bill as it aligns with our mission to maximize federal funding for disability and rehabilitation research programs. A detailed comparison of the Senate bill against the House proposal and the President's Budget can be found here. Additionally, we are concerned about disruptions to the federal research agenda and grant funding processes in FY 2026. The six-week government shutdown has already caused significant setbacks, and we face the possibility of additional delays if another shutdown occurs after the current Continuing Resolution expires on January 30, 2026. A full year of appropriations for HHS would allow federal research entities to plan out the rest of the year.

Attached is a letter to Senate leadership and the Appropriations Committee endorsing the Senate L-HHS bill. This letter reinforces the message DRRC has consistently conveyed to Congress throughout the year advocating for full funding of critical disability and rehabilitation research programs.
Full details here >>

1. The U.S. Department of Education today announced six new interagency agreements to break up the Department. | Read Press Release here: U.S. Department of Education Announces Six New Agency Partnerships to Break Up Federal Bureaucracy | U.S. Department of Education. We will update you with more details as they become available. The press release includes some details on programs that are moving to Department of Labor, Department of Health and Human Services, Department of State, and Department of Interior.

2. The Senate is developing a “mini-bus” appropriations package that includes funding for several departments, notably the Department of Health and Human Services. GOP leadership is considering which bills to combine with Department of Defense funding, including appropriations for Labor, HHS, Transportation, HUD, Interior, Commerce, and Justice. The Senate L-HHS bill in consideration includes $116.9 billion for the Health and Human Services Department, a 1.6% increase from fiscal 2025 levels. The bill would not enact deep cuts to education and health programs requested by the White House. The Senate bill is strongly preferred to the House’s bill which includes cuts to programs like NIDILRR and CDC. More funding levels are detailed in the DRRC memo from September comparing the House, Senate, and President’s Budget Request: DRRC Memo on FY 2026 Appropriations: House, Senate, President's Budget Request (D1196621).DOCX and spreadsheet.

ACRM Signed onto a draft letter to the Chairs and Ranking Members of House and Senate Appropriations Subcommittees on Labor, Health and Human Services, Education and Related Agencies (L-HHS).
Full details here >>

DRRC Congressional Appropriations = Summary of Disability and Rehabilitation Programs in Senate and House
L-HHS Appropriations Bill for Fiscal Year (FY) 2026 and President’s Budget Request for FY 2026 DRRCFY 2026 Appropriations >>
Full details here >

Today, the House Appropriations Committee released the report for fiscal year (FY) 2026 for Labor, Health and Human Services, Education, and Related Agencies (L-HHS). The committee report is a detailed description of the budget and the programs funded. The House bill, report, and summary are linked below. The full committee markup of the L-HHS bill is scheduled for tomorrow, Tuesday, September 9 at 11 (ET).

• House L-HHS Report for FY 2026: https://docs.house.gov/meetings/AP/AP00/20250909/118593/HMKP-119-AP00-20250909-SD002.pdf

• House L-HHS Bill for FY 2026: https://appropriations.house.gov/sites/evo-subsites/republicans-appropriations.house.gov/files/evo-media-document/fy26-labor-health-and-human-services-education-and-related-agencies-subcommittee-mark.pdf

• Summary: https://appropriations.house.gov/sites/evo-subsites/republicans-appropriations.house.gov/files/evo-media-document/fy26-labor-health-and-human-services-education-and-related-agencies-subcommittee-summary.pdf

Upon initial review, NIDILRR would be funded at $100 million (decrease of $19 million from FY 2025). The House would appropriate $47.8 billion for NIH (decrease of $456 million from FY 2025). Agency for Healthcare Research and Quality (AHRQ) would not be funded. CDC would be funded at $7.4 billion (decrease of $1.7 billion from FY 2025).

The Disability and Rehabilitation Research Coalition (DRRC) requests that you to review the letter in this link (https://forms.gle/tvhRESXyEeCvYRk6A) to determine whether you are willing to sign on to support full funding for medical rehabilitation and disability-related research at the National Institutes of Health (NIH), particularly, the National Center for Medical Rehabilitation Research (NCMRR) within the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), in the FY 2026 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill.

In addition, NIH Director, Jay Bhattacharya, MD, Ph.D., will testify before the Senate Appropriations Committee on June 10th at 10:00 AM (ET). We plan to submit this letter for the record of this hearing and distribute it widely among all Senate offices. We urge all DRRC members and NIH supporters to use the Google link above to review and sign on to the letter, as well as submit your own individual organizational testimony. Here is guidance from the committee on submitting outside witness testimony: https://www.appropriations.senate.gov/imo/media/doc/owt_guidelines_lhhs_fy_26.pdf Deadline to sign on is June 9
Full details available here >>

Letter to Senator Tammy Duckworth in support of NIDILRR funding call to action Full details available here >>

Earlier this week, we met with Rep. Andrew Clyde (R-GA) on the House LHHS Appropriations Subcommittee. We created 3 one (or two) pagers for DRRC conversations that are attached to this email for your use and distribution: About DRRC, NCMRR/NIH, and NIDILRR Full details available here >>

Earlier this week, we met with Rep. Andrew Clyde (R-GA) on the House LHHS Appropriations Subcommittee. We created 3 one (or two) pagers for DRRC conversations that are attached to this email for your use and distribution: About DRRC, NCMRR/NIH, and NIDILRR Full details available here >>

Earlier this week, we met with Rep. Andrew Clyde (R-GA) on the House LHHS Appropriations Subcommittee. We created 3 one (or two) pagers for DRRC conversations that are attached to this email for your use and distribution: About DRRC, NCMRR/NIH, and NIDILRR Full details available here >>

Strong opposition letter to Honorable Robert F Kennedy Jr Of inquiry requesting the President, and directing the Secretary of Health and Human Services, to transmit respectively, to the House of Representatives certain documents relating to the elimination of the Administration for Community Living Full details available here >>

Strong opposition letter to Honorable Robert F Kennedy Jr Of inquiry requesting the President, and directing the Secretary of Health and Human Services, to transmit respectively, to the House of Representatives certain documents relating to the elimination of the Administration for Community Living Full details available here >>

House Democrats submitted a resolution requesting President Trump and Secretary Kennedy to answer questions relating to the elimination of the ACL Full details available here >>

Bills-119hes344ih.pdf (Filing of a letter to 119th Congress 1st Session H. RES. 344 Of inquiry requesting the President, and directing the Secretary of Health and Human Services, to transmit respectively, to the House of Representatives certain documents relating to the elimination of the Administration for Community Living.) Full details available here >>

HHS has announced sweeping restructuring, including the launch of the Administration for a Healthy America (AHA), which merges agencies like SAMHSA, HRSA, and others to focus on primary care, mental health, and environmental health. Notably, the Administration for Community Living (ACL) will be dissolved, with its programs reassigned to the Centers for Medicare & Medicaid Services (CMS), the Assistant Secretary for Planning and Evaluation (ASPE), and the Administration for Children and Families (ACF). ACRM, as part of DRRC, is closely monitoring developments and will continue to keep our community informed. Full details available here >>

The letter addressed to OMB, HHS, and NIH raising concerns about the indirect cost policy (more details below in previous emails). It’s focused on the importance of disability and rehabilitation research in general and the impact reductions of funding as a result of the indirect cost cap could have on the future of research. Full details available here >>

As a member of Disability & Rehabilitation Research Coalition (DRRC), ACRM supports NIH’s efforts to enhance disability research, emphasizing the importance of implementing the Strategic Plan for Disability Health Research FY26-FY30. The DRRC advocates for evidence-based care to improve health, function, quality of life, and independence for Americans with disabilities. The coalition urges the NIH to prioritize biomedical, functional, and outcomes research for the 70 million adults and 4 million children with disabilities. Please reach out to the ACRM Policy and Legislation Committee with your thoughts and suggestions. Full details available here >>

Due to the serious consequences of the Trump Administration’s freeze of Federal financial assistance for many programs and activities of significance to the disability community, DRRC Co-Coordinators plans to send the attached letter expressing our concerns, briefly, to the Office of Management and Budget at COB today. Full details available here >>