Congress Adjourns for July Recess With Positive Committee Actions

In Brief: In late June, Congress had adjourned for recess with major Medicare health policy issues unresolved including the outpatient therapy caps exceptions process and the physician fee cuts. However, various Senate and House committees’ actions were favorable and are of interest to physiatrists. This information was current at press time. Updates are available on the Academy web site and in the new e-message, AAPM&R Connection.

NIDRR funding for health and function research included in Senate Appropriations bill

The Senate Appropriations Committee adopted the recommendations of the Disability and Rehabilitation Research Coalition (DRRC) to increase the appropriations level for the National Institute on Disability Rehabilitation Research (NIDRR) to $2 million for FY 2009. The committee targeted the increase to restore support for health and function research. In addition, according to the committee’s report, “The Committee recommends funds above the budget request to restore the number of rehabilitation research and training centers, focusing on the issues of traumatic brain injury, arthritis, neuro-muscular disease, and spinal cord injury. Centers on these topics were previously funded by NIDRR. NIDRR shall award funds for these centers on a competitive basis.”

The Academy’s joint efforts proved highly successful, as AAPM&R is part of DRRC. Formerly known as the National Center for Medical Rehabilitation Research (NCMRR) Coalition, DRRC also consists of the American Congress of Rehabilitation Medicine (ACRM), the Association of Academic Physiatrists (AAP), and other national health professions and consumer organizations.

Congress approves FY 2009 budget resolution

The House of Representatives and the Senate approved the final fiscal year (FY) 2009 budget resolution marking the beginning of the annual appropriations process. The resolution provides:

• $436.2 billion for overall domestic discretionary spending for FY 2009, including $30 billion for the National Institutes of Health (NIH) and $48.2 billion for veterans programs including medical care

• Reserve funds for the State Children’s Health Insurance Program (SCHIP)

• Changes to Medicare including increasing reimbursement rates for physician services and adjustments to the Medicare Savings program

Americans with Disabilities Act (ADA) Amendments of 2008

The ADA Restoration Act (or H.R. 3195, now referred to as the “ADA Amendments of 2008”) passed the House of Representatives on June 25 by a vote of 402-17. The fundamental goal of the Americans with Disabilities Act (ADA) is to ensure that individuals with disabilities are treated with dignity and respect and not denied opportunities based on discrimination (through fear, ignorance, stereotypes, and so on). Under the ADA, an individual is protected against discrimination if he or she has an impairment that substantially limits a major life activity, has had a record of such an impairment, or is regarded as having such an impairment.

The ADA Amendments of 2008 will re-establish protections against discrimination by helping to overturn Supreme Court decisions that have inappropriately narrowed the definition of disability. The narrowing of interpretation has resulted in the exclusion of many people with disabilities whom Congress originally intended to protect against discrimination. For example, such decisions created an illegal “catch 22” under which many individuals with disabilities were deemed by the courts as “not disabled enough” to qualify for ADA protections because they were not hired or fired because of their disabilities. The bill includes the following key provisions:

• Coverage: Clarifies that Congress intended the ADA’s coverage to be broad, to cover anyone who faces unfair discrimination because of disability

• New definition of “substantially limits”: Retains the requirement that an individual’s impairment must substantially limit a major life activity but provides a new definition of “substantially limits” that makes it easier to qualify

• Protection for mitigating measures: Will overturn several court decisions to ensure people with disabilities will not lose their coverage under the ADA simply because their condition is treatable with medication or can be addressed with the help of assistive technology

• Clarifies the use of “regarded as”: Retains the “regarded as” prong of the definition but clarifies that the definition of disability includes situations where an employee is discriminated against because of his or her actual or perceived impairment. The bill also makes it clear that accommodations do not need to be made for someone who is disabled solely because he or she is “regarded as” having an impairment.

The overwhelming bipartisan support for the legislation was the result of a coalition of civil rights, disability, and employer communities that came together to craft a bill to provide a proper balance between protections for people with disabilities and the obligations and requirements of employers. The proposed legislation will now go to the Senate for consideration.

For more information on these issues, please contact Suzanne Butler, JD, manager of legislative affairs, at legislativeupdate@aapmr.org.
 

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