Brain and Spine Injury Law Blog

Brain and Spine Injury Law Blog

Liability Medicare Set Aside – CMS Gearing Up to Reject Medicare Claims Related to Liability Settlements

Posted in Brain Injury News and Event Update, Uncategorized
Tim Titolo

Last week, the Centers for Medicare and Medicaid Services (CMS) released a “CMS Manual System” “One-Time Notification” regarding Liability Medicare Set Asides and enforcement of the Medicare Secondary Payer statute (MSP). Starting October 1, 2017, Medicare and their contractors will reject medical claims submitted post-resolution of a liability settlement on the basis those claims “should be paid from a Liability Medicare Set Aside (LMSA).”

B. Josh Pettingill, of Orlando based Synergy Settlement Services, says, “At the heart of the announcement is the following text which Synergy has continually indicated was CMS’s position regarding liability settlements and enforcement of the MSP:

‘Pursuant to 42 U.S.C. §1395y(b)(2) and §1862(b)(2)(A)(ii) of the Social Security Act, Medicare is precluded from making payment when payment “has been made or can reasonably be expected to be made under a workers’ compensation plan, an automobile or liability insurance policy or plan (including a self-insured plan), or under no-fault insurance.” Medicare does not make claims payment for future medical expenses associated with a settlement, judgment, award, or other payment because payment “has been made” for such items or services through use of LMSA or NFMSA funds. However, Liability and No-Fault MSP claims that do not have a MSA will continue to be processed under current MSP claims processing instructions.’

“Enforcement of the MSP as it pertains to future Medicare covered services began back in 2001 when CMS announced in a policy memorandum the requirement to set aside a portion of workers’ compensation settlements allocated to future Medicare covered expenses. Accordingly, the MSP enforcement only took place in the context of workers’ compensation matters. The practical implication of this memorandum was the advent of the Medicare set aside. In 2007, Section 111 Reporting Requirements (part of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA)) added a mechanism for CMS to track Medicare beneficiaries who receive liability, workers’ compensation or no-fault liability settlements, judgments or awards. This Section 111 Reporting Requirement gave CMS further ammunition to track compensable ICD codes related to the liability case.

There has been little to no enforcement of MSP in the context of liability settlements up until now. In most instances, Medicare has continued to process medical claims as if there never were a recovery made for future medical care. On very rare occasions, they would deny medial claims submitted by providers.  This latest commentary indicates an imminent change in the near future in regards to enforcement of the MSP. CMS is subtly sending the message that LMSAs are going to be a necessary mechanism in order to avoid denial of medical claims post-resolution. They are also suggesting there will be certain cases where LMSAs will not be necessary; although, this latest alert did not specify these circumstances.”

juridical concept with hammer and lawbook, selective focus on metal part,toned f/xMedicare Set Asides require an attorney get a professional estimate of future care costs and invest a portion of the trial verdict or settlement amount to fund those costs.  This prevents medicare recipients from using tax money to pay for health care when they have been paid, in theory, for their future medical care in the lawsuit result.  The process is murky but the horizon appears clear and less murky. MSAs are coming.

 

Here is a link to the announcement:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1787OTN.pdf

American Health Care Act Limits Brain Injury

Posted in Attorney Selection, Brain Injury News and Event Update, Legislation, Psychiatric & Psychological Issues, Publications, Resources, Soldiers, Veterans and Military Issues, Traumatic Brain Injury (TBI)
  • At a time when Americans are concerned about health care being too expensive, the AHCA raises premiums 20 percent, charges people over the age of 50 five times more than younger enrollees and increases out-of-pocket costs and deductibles while leaving 24 million more people uninsured.
  • The changes made yesterday to Essential Health Benefits make coverage worse for almost everybody.
  • It effectively eliminates annual out-of-pocket caps and reinstates annual and lifetime coverage limits.
  • It guts protections for preexisting conditions, because most insurance policies won’t include coverage for essential benefits, like rehabilitation, resulting in soaring costs for those who need them.
  • Medicaid cuts and changes to health insurance rules will dramatically limit access for individuals living with brain injury.

House Committees Pass Reconciliation Bill Affecting Health Care

Posted in Age & Alzheimer's Issues, Books, Articles, and Literature, Legislation, Psychiatric & Psychological Issues, Publications, Resources, Traumatic Brain Injury (TBI)
Tim March 2016 (450x800)

Health Care Bill

This week, two House Committees expedited legislation to repeal the Affordable Care Act (ACA) and dramatically reduce and change the Medicaid program. The Committees debating the bill were the House Energy and Commerce Committee and the House Ways and Means Committee. Congress is using the reconciliation budget process to fast track repealing the health care reform bill. The proposal uses cuts in the Medicaid program as a way to pay for it by capping spending and transferring the program to the states to administer. The Brain Injury Association of America (BIAA) sent an Action Alert earlier this week expressing concerns about the bill and will continue to apprise advocates as the bill progresses (view the Action Alert here). BIAA also sent a letter of support to the Ways and Means Committee in support of Congressman Pascrell’s (D-N.J.) amendment to protect individuals with Traumatic Brain Injury (TBI) by maintaining current premium tax credits and cost-sharing reduction (CSR) subsidies in order to purchase a health plan in the private individual health insurance market.

Traumatic Brain Injury Victims versus President Trump and Republican Congress

Posted in Brain Injury News and Event Update, Personal Injury, Soldiers, Veterans and Military Issues, Traumatic Brain Injury (TBI)
BIAA

The Brain Injury Association of America enriches us with activity in government updates.  Of particular interest is the deconstruction of our nation’s health care. The Affordable Care Act is being dismantled in favor of a yet unknown substitute.

Recently President Trump called for an investigation of alleged Obama wire taps accusing President Obama of listening in on his private conversations.  This is a distraction from the ongoing and getting worse Russia situation.  It will be interesting if the alleged Russian contact ever testifies about the conversations he had with the, now, Attorney General, Jeff Sessions, who recused himself from the scandal for unknown reasons.  Usually a Judge will recuse himself for conflicts such as, having an interest in a business of one of the litigants, or other relationship with one of the parties. This seems to be, perhaps, the Attorney General having participated in the disputed facts.

A few days ago, the Senate confirmed Dr. Ben Carson to head the U.S. Department of Housing and Urban Development (HUD), and former Texas governor Rick Perry as the secretary of the U.S. Department of Energy.

Please read through to my conclusion at the end. Please post any comments as we are interested in your opinion. We are now in March 2017. Here are things you should know about that will affect us all.

March 3, 2017

President’s Speech to Congress

Although not billed as a State of the Union Address, President Trump delivered his first speech to Congress Tuesday night. Among his legislative agenda is to repeal and replace the Affordable Care Act (ACA), overhaul taxes, fund a trillion-dollar infrastructure program, and increase military and security spending. To pay for the proposed increase of $54 billion for the military, the President is proposing to cut about the same amount from non-defense discretionary programs. Non-defense discretionary programs refer to programs which receive an annual appropriation, such as programs authorized by the Traumatic Brain Injury (TBI) Act.

The President sent his blueprint for his budget recommendations to government agencies on Monday, whereby federal agencies will recommend program cuts and elimination in order to achieve the President’s goal of increasing defense spending. At the same time, the President is not calling for cuts from veterans’ programs, law enforcement, or entitlement programs (i.e., Medicaid, Social Security, etc.).

House GOP Plans to Mark Up Health Care Proposal

There are conflicting stories as to the House Ways and Means and the Energy and Commerce Committees’ intent on voting on the repeal of the Affordable Care Act (ACA) starting next week. The disability community received word that the Energy and Commerce Committee is to mark up a bill next week and then the Ways and Means Committee will hold a hearing after that to discuss taxes associated with the ACA. As such, the Consortium for Citizens with Disabilities (CCD), of which the Brain Injury Association of America is a member, sent an organizational sign on letter calling into question the Committees’ intent to repeal and replace the health care plan without opportunity for public input.

Lawmakers have floated their intentions of restructuring the Medicaid program by shifting the entitlement program to one with per capita caps or turning the program into a block grant program with a fixed amount to states and for the states to administer. The goal is to cut Medicaid costs in order to offset the costs associated with the repealing of taxes pertaining to the ACA. Politico reported that House Energy and Commerce Chair Greg Walden (R-Ore.) said he would be sharing an “initial staff draft” with Committee Members this Thursday. He didn’t say when it would become public or confirm any markup hearing in his Committee next week.

Republican leaders have been calling for a replacement bill that would cover pre-existing conditions, encourage health savings accounts, offer tax credits, and provide assistance for state high risk pools for those with health conditions. Meanwhile, the Kaiser Family Foundation has posted information about the current proposals on its website to allow you to compare the ACA and four of the proposed replacement plans. That resource is available here.

Advocates Asked to Help CBITF Circulate Letter in Support of Funding for TBI Programs

With the current environment focused on cutting federal funding next year, advocates are called on to help support funding for TBI Act programs, NIDILRR Model Systems, and research by asking their U.S. Representatives to sign on to a Congressional Brain Injury Task Force (CBITF) letter being circulated by Co-chairs, Bill Pascrell, Jr. (D-N.J.) and Tom Rooney (R-Fla.). The letter is available here. Advocates are also invited to attent the CBITF annual Awareness Day activities scheduled for March 22. This is an excellent time to meet with your Representatives and Senators to educate them on brain injury and funding needs.

 Congress Marks Up Defense FY 2017 Spending Bill

While energy is now placed on funding for the next fiscal year, the funding for the current year ends April 28. Congress will need to enact an appropriations bill(s) or a continuing resolution to continue federal government through Sept. 30. This week, the House Appropriations Committee introduced the final version of the fiscal year (FY) 2017 Defense Appropriations bill, which will be considered on the House floor next week. The agreement provides $312 million for cancer research, $125 million for traumatic brain injury and psychological health research, and $296 million for sexual assault prevention and response. All of these funding levels represent increases above the budget request for these programs.

 Senate Confirms President’s Cabinet Nominations

Yesterday, the Senate confirmed Dr. Ben Carson to head the U.S. Department of Housing and Urban Development (HUD), and former Texas governor Rick Perry as the secretary of the U.S. Department of Energy.

 

TimIn Conclusion  

There appear to be major and minor rifts happening which will be felt soon. The health care we receive will be changing again. Our fund appropriated Brain Injury Programs and those of affiliated partners will suffer. The quality of care to those who are receiving and those who would have benefited from such care will reduce.

What happens next will be known when it happens as, so far, this administration has been predictably unpredictable.

We are all interested in current events whether we realize it or not. From keeping abreast via the internet or social media, watching the 30 minute news segment or other news channels, to old fashioned reading of newspapers: we all absorb our environment and, hopefully, seek successful social networks.  Therefore what happens in our town, state, nation, world and universe, is of interest.  PLEASE take a few moments to share your reaction to this post, either my commentary or the substantive portion from the BIAA, or both.  Thank you.

Brain Injury Conference

Posted in Brain Injury News and Event Update

My friend, Sherry Stock of the Pacific NW Brain Injury’s 15th Annual Conference, asked me to post this for my readers.  I have participated in this conference

Sherry Stock

 

Don’t Miss Out  Early Registration Deadline is Fast Approaching!

Join Us For Our Annual Conference!

 

Thursday, March 9

 

Friday & Saturday, March 10 & 11

 

This preconference workshop is designed for health care professionals, AFH, RCF, caregivers and family members seeking instruction on dealing with challenging behaviors, resources and general  knowledge.

 

This conference is for professionals working with individuals living with brain injury individuals with brain Injury, and caregivers. It is a great opportunity to learn more about current issues including veterans, the latest treatments, support services and resources for those involved with the brain injury community. 

 

Co-Hosted By:

The Brain Injury Alliance of Oregon

The Brain Injury Alliance of Washington The Brain Injury Alliance of Idaho Alaska Brain Injury Network

 

 

Conference Flyer        Conference Website      Conference Registration

 

Brain Injury Alliance of Oregon  Mailing Address: PO Box 549, Molalla OR 97038 800-544-5243 fax: 503.961-8730  biaor@biaoregon.org sherry@biaoregon.org http://www.biaoregon.org  IRS 501(c)(3) organization Tax ID: 93-0900797 “If a disease were killing our children in the proportions that [brain] injuries are, people would be outraged and demand that this killer be stopped.”  former Surgeon General Everett Koop, MD.

 

Life Care Planning for Pediatric Brain Injury

Posted in Brain Injury News and Event Update

This case involves the neonatal care of a boy who was born under the circumstances of a prolonged delivery. At birth doctors obtained an APGAR score of 7 and the child was observed for a day and a half, after which he was discharged to home, allegedly jaundiced. He was brought for evaluation by a pediatrician who diagnosed the baby with jaundice. He was readmitted to the hospital and was administered a transfusion. An MRI was conducted, and he was diagnosed with severe brain damage. A follow-up MRI reconfirmed the presence of brain damage. The child will require a lifetime of ongoing care, and was assessed by a life care planner in order to project the expense of this care throughout his life.

 Question(s) For Expert Witness

  • 1. Do you routinely assess long-term needs for pediatric patients that have endured similar birth complications?
  • 2. Are you familiar with the neurospychological and cognitive limitations that may evolve from clinical diagnoses such as those described in this case?

Expert Witness Response E-080381

Pediatric LCP’s of this nature are complicated. There is a need to work with a physician that can tie everything together, preferably a pediatric physiatrist. A home visit is necessary. If you desire an opinion regarding lost earning capacity I need to be able to evaluate parents and have access to sibling information regarding their education thus far. I have developed numerous pediatric LCP’s over the last 20+ years. These plans have been related to birth injury or trauma. In my practice I do a considerable amount of school transition planning. I work with neuropsychologist’s and their reports frequently. This case will require a great deal of care, due to the extensive nature of the child’s injuries as well is the extended period of time over which he will require ongoing care.

BIAA Update February

Posted in Uncategorized

Lawmakers Introduce Therapy Cap Bills

Rep. Erik Paulsen (R-Minn.) has introduced H.R. 807 to repeal the Medicare outpatient rehabilitation therapy caps. The legislation currently has 46 co-sponsors. Senator Ben Cardin (D-Md.) has introduced a companion bill, S. 253. So far, three senators have agreed to co-sponsor the legislation. The Medicare cap on outpatient rehabilitation therapy services was originally instituted under the Balanced Budget Act of 1997 as a combined cap on speech-language pathology (SLP) and physical therapy (PT) services, as well as a separate cap on occupational therapy (OT) services to Medicare beneficiaries. The 2013 “Path for SGR Reform Act of 2013” law directed the Centers for Medicare and Medicaid Services (CMS) to continue to allow exceptions to therapy caps for medically necessary services provided through March 31, 2014. The therapy cap exceptions process has since required reauthorization annually.

Republicans Pursue Repealing the ACA

Republican lawmakers are moving forward to repeal and replace the Affordable Care Act (ACA). Last week and this week, committees held a flurry of hearings. Both the House Budget Committee and the House Ways and Means Committee held separate hearings on the “failings” of the program and in particular, the effectiveness of the individual mandate requirement, which was discussed by the House Ways and Means Committee. This week, the House Energy and Commerce Committee held two hearings on Medicaid and the House Education and the Workforce Committee held a hearing called “Rescuing Americans from the Failed Health Care Law and Advancing Patient-Centered Solutions.” The House Energy and Commerce Committee’s Subcommittee on Oversight and Investigations examined the Medicaid expansion program.

The Senate Finance Committee and the Health, Education, Labor and Pensions (HELP) Committee are also studying specific proposals. The Senate HELP Committee held a hearing on stabilizing the insurance market. These House and Senate committee hearings follow the budget resolution passed by both the House and Senate, which contained provisions for repealing and replacing the health care reform legislation. Last week, President Trump signed an Executive Order to give federal agencies latitude in delaying or waiving provisions, rules and regulations with regard to the ACA that would place a fiscal burden on states, individuals, families, health care providers, health insurers, or makers of medical devices, products or medications.

Congressional Brain Injury Task Force Schedules Awareness Day

Mark your calendar for the 2017 Brain Injury Awareness Day on Capitol Hill to be held Wednesday, March 22, 2017. The day will begin at 10 a.m. with a Brain Injury Awareness Fair to be held in the Rayburn Foyer, followed by the briefing, “Faces of Brain Injury: The Invisible Disability Affecting Children and Adults,” to be held in the Rayburn Gold Room 2168. A reception will  also be held in the Rayburn Gold Room 2168 from 5 p.m. – 7 p.m. The Brain Injury Association of America (BIAA) is a sponsor of the reception and will be actively involved in the day’s events.

Senate Committee Approves Education Nominee

Early this morning, the U.S. Senate voted to advance the confirmation of Betsy DeVos as Secretary as the U.S. Department of Education, President Trump’s pick. The final confirmation vote is expected to take place Monday. The vote this morning was 52 to 48 along party lines. Two republicans have indicated they will vote against her on the final vote Monday, Senators Susan Collins of Maine and Lisa Murkowski of Alaska, which would result in Vice President Pence casting the tie breaker vote.

President Trump Issues Executive Order on the ACA

Posted in Brain Injury News and Event Update
BIAA
 I have been reading the latest Brain Injury Association’s News and republish the following for my readers.
 Quick Links

BIAA Government Affairs

BIAA Home Page

Academy of Certified Brain Injury Specialists (ACBIS)

Find BIA in Your State

Brain Injury Preferred Attorneys

BIAA Career Center

 

 

BIAA Policy Corner

is an update on federal policy activity related to traumatic brain injury (TBI) and is published weekly when Congress is in session.
The Brain Injury Association of America

is the country’s oldest and largest nationwide brain injury advocacy organization.

Our mission is to advance brain injury prevention, research, treatment and education and to improve the quality of life for all individuals impacted by brain injury.

Through advocacy, we bring help, hope and healing to millions of individuals living with brain injury, their families and the professionals who serve them.

 

The Brain Injury Association of America is grateful to its Corporate Sponsors for their support of our advocacy, awareness, information and education programs. Please visit their Web sites to learn more about their programs and services.

 

 

President Trump Issues Executive Order on the ACA

On Jan. 20, 2017, Donald Trump was sworn in as the 45th President of the United States. Among his first duties was to issue an Executive Order calling for the rolling back of the Affordable Care Act (ACA). The Executive Order directs the Secretary of the Department of Health and Human Services (HHS) and other affected agencies to interpret regulations as loosely as possible to minimize the financial burden on individuals, insurers, and health care providers. Norris W. Cochran, who is the Deputy Assistant Secretary for Budget, is currently serving as the Acting Secretary of HHS until the president’s nomination for secretary is confirmed.

 

On Tuesday, the Senate Finance Committee vetted Rep. Tom Price (R-Ga.) who was appointed by President Trump to serve as the HHS Secretary. Committee members questioned his vision for health care, including the Medicaid program. Specifically, the committee members discussed his position on block granting Medicaid and giving the responsibility to the states to determine how to administer. Last week, the Senate Health, Education, Labor and Pensions (HELP) Committee also held a confirmation hearing to consider Rep. Price for the position. The Senate Finance Committee will have the ultimate say as to advancing the candidate to be voted on by the full Senate.

 

Senate Committees Vet Administration Appointees

On Jan. 18, the Senate HELP Committee held a hearing to consider Betsy DeVos as the Secretary of the Department of Education. Several senators questioned her knowledge and support of the Individuals with Education Act (IDEA), as well as other responsibilities of the department. Several disability organizations have since expressed concern for her lack of knowledge and support for IDEA. The chairman of the committee has postponed the confirmation vote until Jan. 31 to give committee members time to review her ethics committee report.

 

On Tuesday, the Senate Committee on Commerce, Science and Transportation voted unanimously to approve Elaine Chao as Secretary of the Department of Transportation. She testified before the Senate Committee on Commerce, Science, and Transportation Jan. 11. She will need to be confirmed by the full Senate before assuming the position

 

Federal Agency Directors Submit Required Resignation Letters

Francis Collins, M.D., Ph.D., submitted his resignation as the director of the National Institutes of Health (NIH) effective Jan. 20, in keeping with tradition of non-termed political appointees to vacate their positions for the new Administration to fill. His resignation letter was returned and he was instructed that he will be staying on until further notice. Tom Frieden, M.D., has stepped down as the director of the Centers for Disease Control and Prevention (CDC). Deputy Director Anne Schuchat, M.D. is serving as the Acting Director. John Tschida, who has served as the director of the National Institute on Disability and Rehabilitation Research (NIDILRR) since March 2014, has also vacated his position.

 

Federal Agencies Notified to Curb External Communications

Several federal employees, including HHS employees, have received a memo calling for a halt to external correspondence until Feb. 3. HHS operating Divisions have also been notified to hold off on publishing new rules or guidance in public forums until the new Administration has time to review them.

 

Rep. Walden to Introduce Bill to Protect Persons with Pre-existing Conditions

House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) has indicated his plans to introduce legislation to ensure that individuals with pre-existing conditions continue to receive health care coverage. He announced his intentions in an interview with CNN reporter, Jake Tapper. He also expressed support for giving governors flexibility with regard to a new health care plan.

 

Congressional Brain Injury Task Force Announces Awareness Day

As co-chairs of the Congressional Brain Injury Task Force, Reps. Bill Pascrell, Jr.(D-N.J.) and Thomas J. Rooney (R-Fla.) have sent invitations for participation in the 2017 Brain Injury Awareness Day on Capitol Hill to be held Wednesday, March 22, 2017. As in past years, the day will begin at 10 a.m. with a Brain Injury Awareness Fair to be held in the Rayburn Foyer, followed by the briefing, “Faces of Brain Injury: The Invisible Disability Affecting Children and Adults,” to be held in the Rayburn Gold Room 2168. A reception will be held in the Rayburn Gold Room 2168 from 5 p.m. – 7 p.m. The Brain Injury Association of America (BIAA) is a co-sponsor of the reception and will be actively involved in the day’s events.

 

 

Brain Injury Association of America January 2017 Update

Posted in Brain Injury News and Event Update, Legislation, Traumatic Brain Injury (TBI)
January 13, 2017

Senate Votes to Repeal ACA in Budget Resolution

The Senate conducted a “vote-a-rama” Wednesday night until early Thursday morning considering a number of amendments supported by Democrats to S. Con. Res. 3, the budget resolution bill, to stall the total repeal of the 2010 Patient Protection and Affordable Cart Act (ACA). The Senate used the budget resolution bill as a way to repeal the ACA, since the budget resolution requires only a simple majority vote. The ACA was enacted by the same process.

None of the amendments offered by Democrats passed the Senate. The Brain Injury Association of America (BIAA) supported an amendment offered by Senators Mazie K. Hirono (D-Hawaii) and Joe Donnelly (D-Ind.), along with 17 Senate Democrats, to prevent changes to the Medicare and Medicaid programs without a supermajority in the Senate (60 votes). The Hirono-Donnelly amendment created a budget point of order to prevent changes to Medicare that raise the eligibility age, change eligibility requirements, or privatize and voucherize the program. The amendment also was to prevent changes to Medicaid that would reduce state funding from current levels. Any changes to either program would have required a supermajority in Congress. The amendment failed 49-47 with two Republicans voting for the amendment – Senators Susan Collins (R-Maine) and Dean Heller (R-Nev.). A wide range of organizations supported the amendment, including AARP, AFL-CIO, American Federation of State, SEIU, National Education Association, Healthcare Association of Hawaii, Hawaii Public Health Association, and the National Committee to Preserve Social Security and Medicare.

In the end, the Senate voted for the resolution early Thursday morning stripping fees, taxes, and subsidies relating to the ACA. Sen. Rand Paul (R-KY) was the lone Republican opponent of voting on a repeal bill before coming up with a replacement package. Democratic Sen. Dianne Feinstein (D-Calif.) was absent for the vote.

The reconciliation budget for 2017 sets levels of new budget authority, revenues, outlays and deficits for 10 years and projects Social Security funding also over 10 years. The bill directs certain Senate and House committees to each find at least $1 billion in cost cutting over 10 years and estimates the deficit to be over $1 trillion in 10 years as well. The bill largely retains parliamentary procedures such as dynamic scoring, a process under which The Congressional Budget Office (CBO) calculates the economic impact of bills out 40 years. The bill also shows Social Security in the black over the next 10 years. The House is poised to take up similar legislation.

 Lawmakers to Introduce Bills to Repeal Therapy Caps

Lawmakers in both Houses have indicated plans to sponsor legislation to repeal therapy caps. Rep. Erik Paulsen (R-Minn.) and Rep. Ron Kind (D-Wis.) will introduce legislation in the House and Senators Ben Cardin (D-Md.), Susan Collins (R-Maine), Bob Casey (D-Pa.), and Dean Heller (R-Nev.) will introduce the Senate version. Under the Balanced Budget Act (BBA) of 1997, Congress placed an annual cap on rehabilitation services under Medicare. Since enacting the BBA, Congress has acted several times to prevent implementation of a hard cap. BIAA has signed on to the Therapy Cap Coalition’s letter to Members in support of the legislation.

Legislator Introduces Bill for Adult Day Programs

Rep. Barbara Lee (D-Calif.) has introduced H.R. 325 to expand and enhance existing adult day programs for younger people with neurological diseases or conditions, including traumatic brain injury (TBI), in order to support and improve access to respite services for family caregivers who are taking care of individuals with these conditions. She has introduced similar legislation in previous years.

Coalition Sponsors Briefing on Violence and Sexual Assault against Women

The National Science Coalition to Improve Lives is sponsoring a congressional briefing Feb 1. entitled “Violence and Sexual Assault against Women: Reducing its Prevalence via an Evidence-based Prevention Approach.” The briefing will take place from 1 p.m. – 2:30 p.m. in Room 2200 at the Rayburn House Office Building. Speakers include Rep. Gwen Moore (D-Wis.) and nationally-recognized experts on violence and sexual assault against women who will provide an overview of the problem and then discuss the sources of violence in particular settings and situations.

 

President-elect Appoints VA Secretary

President-elect Donald Trump has appointed David Shulkin, M.D., as Secretary of the Department of Veterans Affairs. He is currently the undersecretary having been appointed by President Barack Obama June 15, 2015. Dr. Shulkin received his medical degree from the Medical College of Pennsylvania and did his internship at Yale School of Medicine, and his residency and fellowship in General Medicine at the University of Pittsburgh Presbyterian Medical Center. He previously served as the president and chief executive officer of Beth Israel Medical Center in New York City and also served as president of Morristown Medical Center and the Atlantic Health System Accountable Care Organization.

U.S. Supreme Court Holds Oral Arguments on the IDEA FAPE Mandate

This week, the U.S. Supreme Court heard oral arguments in Endrew F. v. Douglas County School District, on the meaning of the free appropriate public education (FAPE) mandate for students with disabilities under the Individuals with Disabilities Education Act (IDEA). The case involves a child with autism whom the parents placed in a private school for services the parents believed to be more appropriate than what the public school provided. The parents are seeking reimbursement for the child’s tuition and related expenses. The question the Court is pondering is what educational benefits are guaranteed to a child with a disability by a public school under IDEA.

In response, Senator Patty Murray (D-Wash.), Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released a statement this week expressing concerns regarding the potential of rolling back fundamental protections and attempts to divert taxpayer dollars from public schools to fund private school vouchers that do not help all students. She is hoping that the Court will preserve Congress’ intent in IDEA to provide students with disabilities meaningful educational benefit from the instruction and services they receive. In November 2016, Senator Murray and Rep. Bobby Scott (D-Va.) led a bicameral group of 118 current and former Members of Congress in filing an amicus brief in the case, arguing that the statute clearly intended to provide meaningful and material educational benefits to students with disabilities so that they may reach their full potential and live independent lives.

ACL Staff Sends Message About Departure

Aaron Bishop, Commissioner of the Administration for Disabilities, acknowledging that his tenure will soon be coming to an end, sent a message to friends and advocates about his time with the newly created Administration for Community Living (ACL). Among ACL’s initiatives and accomplishments, was the transfer of the Federal TBI Grant Program from the Health Resources and Services Administration (HRSA) to the ACL. He supported the transfer and worked with stakeholders accordingly. He expects to be leaving Jan. 20 when the new Administration effectively begins.

Living With Brain Injury: Embracing the Future – Pacific Northwest Conference

Posted in Brain Injury News and Event Update

 

34th Annual Brain Injury Conference

 

Living With Brain Injury: Embracing the Future

 

15th Annual Pacific Northwest Brain Injury Conference

 

 

 

 

Join Us March 9-11!

 

Come join us for the 15th Annual Northwest Brain Injury Conference and the 34th Annual BIAOR Conference

 

Certified Brain Injury Specialist Training

The Academy of Certified Brain Injury Specialists (ACBIS) offers a voluntary international certification program for both entry-level staff and experienced professionals working in brain injury services. ACBIS provides staff and professionals the opportunity to learn important information about brain injury, to demonstrate their learning in a written examination, and to earn a nationally recognized credential. Certification is based on a comprehensive training book that covers the following topics: Incidence and epidemiology of brain injury Continuum of services Brain anatomy and brain-behavior relationships Functional impact of brain injury Effective treatment approaches Children and adolescents with brain injury Health and medical management Family issues Legal and ethical issues The Brain Injury Alliance of Oregon is offering a training program geared toward preparing for the CBIS examination. This training will be delivered in a one day workshop.  Students must attend the entire session. The workshop will include: The Essential Brain Injury Guide, study materials and interactive workshop with Sherry Stock, Certified Brain Injury Specialist Trainer. The National Online Examination will be scheduled within two weeks of the class.  For more information

 

The Pre-Conference, March 9, will focus on Challenging Behaviors and how to use music, art and physical activities to manage them.  Music, art and physical therapists, as well as providers and caregivers, will explain and demonstrate how they take an individualized approach when working with clients who are living with a brain injury. The creative arts therapies can be used to improve associated symptoms through interactive art-making experiences designed and adapted to emphasize each client’s strengths. Sensory stimulation through the arts promotes increased attention, while the creation of a story or a song can be used to memorize and recall personal information. Neurologic Music Therapy techniques are utilized to promote rehabilitation of speech and motor abilities through active instrument play, singing and movement to music such as in the case of Congresswoman Giffords. Therapists will demonstrate and discuss, in group sessions throughout the day, how providing music, drama, martial arts and art therapy can improve positive outcomes when dealing with Challenging Behaviors. Therapists will take a collaborative approach and conduct sessions with speech therapists, occupational therapists and physical therapists in a co-treatment model.

Friday and Saturday will focus on the latest technology and treatment available for brain injury. These presentations will include: 

Keynote Speakers Friday, March 10:

Opening Keynote: Veterans and TBI/PTSDCameron Smith, Director, Oregon Department of Veterans Affairs

Afternoon Keynote: Patient, Dr., What’s the Difference  Jacob Plasker, DC

Keynote Speakers Saturday, March 11:

Opening Keynote: The End of Caring: Understanding the Dynamic of Failure in RehabRolf B. Gainer, PhD

Afternoon Keynote: Functional Neurological Management of Persistent Post-Concussion SyndromeDr. Glen Zielinski, DC, DACNB, FACFN 

 

Break-out Presentations will include: 

 

The Medical Perspective of TBI– James Chesnutt, MD

 

The Veteran in Crisis, Brain Injury and Other Traumas-Scott Bloom, CBIS, Mitch Sparks, ODVA

 

Proving Damages in a TBI Case– Richard H. Adler, JD, Jacob Gent, JD, Steven Angles, JD, Melissa D. Carter, JD and Arthur D. Leritz, JD

 

Heal Your Brain, Heal Your Body-Linda Gifford

 

Practical Applications for Behavioral Health Clinicians – Dan Overton, MC, LMHC, MHP

 

The Developing Adolescent Brain: How THC affects the Brain. Shelley Campbell, RN

 

TBI and Psychiatric Illness: A Common Thread of Neuroinflammation –  Shauna Hahn, PMHNP

 

TBI Induced Vision Problems-Juliet Machado, BA

 

What survivors, caregivers and families need to know.  – Dr. Glen Zielinski, DC, DACNB, FACFN

 

Roadblocks to Re-entry: The Triple Whammy of Brain Injury, Psychiatric Disorders and Substance AbuseRolf B. Gainer, PhD Rehabilitation Institutes of America, Novato, California; Neurologic Rehabilitation Institute at Brookhaven Hospital, Tulsa, Oklahoma; Neurologic Rehabilitation Institute of Ontario, Etobicoke, Ontario and Community NeuroRehab, Des Moines, Iowa

 

What are the needs of individuals over 50 in Idaho– Russell C. Spearman M.E

 

Embracing the Journey – Dr. George Siegfried, D.C.

 

Washington State’s Traumatic Brain Injury Advisory Council: A history and the positive impact on the brain injury community-Scott Bloom, CBIS

 

Managing Emotional and Behavioral Disturbances after TBI-Kendra Ward, COTA/L

 

Treating the Medical Needs of Brain Injury Survivors in Alaska– Dr. Adam Grove.

Life After Brain Injury – Panel: How Marriage Roles Change –  Michael Green and Stephanie Slack: Stephanie will share how their personnel story began on 9/29/2010 as a result of a motorcycle accident while on vacation 900 miles from home.  Michael will discuss his unique story-My Life After TBI and Emergency Crainiotomy.  Michael and Stephanie will share then and now, almost 7 years post TBI.  How it has affected their lives within the family network  Brain Injury:  When It’s Not That EasyKeri Stocks. Keri will talk about how a brain injury alters the family dynamics and the effects that these changes have on everyone including family and friends.

Triumph over TBI: Turning Loss into Opportunity Brief – Tanya J. Peterson, MS, NCC

Finding HappinessDan Overton, MC, LMHC, MHP, Traumatic Brain Injury Program Coordinator,  Behavioral Health Services WA. Dept. of Veterans Affairs

 

 

The biggest benefit of attending a conference is connecting with kindred spirits, folks whose work you admire and which inspires you. Conferences have a way of renewing the passion that brings like-minded people together, and being part of collaboration is a privilege that you can truly value. Attending a conference provides an opportunity to learn from experts, share ideas with others, and identify new knowledge and techniques in your field. Given the knowledge explosion in the current information-rich era, attending this conference is a great way to keep abreast of emerging themes and technology and, perhaps most importantly, network.

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Sheraton Hotel Accomodations

 

Hotel Rooms

 

Hotel rooms are available at discounted rates. Use the code BIAOR2013 and reserve your room today by calling 503-281-2500.  Discounted rooms are limited.

 

Sponsored By:

Brain Injury Alliance of Oregon

Brain Injury Alliance of Washington

Alaska Brain Injury Network

Brain Injury Alliance of Idaho

3 day VIP Pass with 24 CEUs
~$500~

 

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When

 

Thursday March 9 – Saturday March 11, 2017

 

Where

 

Sheraton Portland Airport Hotel

8235 NE Airport Way

Portland OR 97220

503.281.2500

 

What

 

An awesome event that you won’t want to miss out on! View More Info

 

 

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Thursday-Saturday

Thursday: An entire day with experts devoted to demonstrating the benefits of music, art and physical therapy to maximize independence and positive outcomes.  Music, art and physical therapy sessions  incorporated throughout conference.  Interactive activities and survivors demonstrating their accomplishments.

 

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