Children’s Sleepwear: Drafted and secured the introduction of the Children’s Sleepwear Safety Act of 1998 and the Safe Sleepwear and Burn Prevention Act of 2002. ABA testified on safe sleepwear issues before the House Energy and Commerce Committee and the Consumer Product Safety Commission.
Fire Safe Cigarettes: Worked with Members of Congress to support legislation regarding Fire Safe Cigarettes, as well as the CPSC to use its regulatory authority to address safety concerns regarding cigarettes.
Flame Retardants and Burn Prevention: Organized a panel discussion regarding the use of flame retardant chemicals in furniture and their effectiveness or lack thereof in preventing fires and serious burn injuries. Worked with California Governor Jerry Brown to curb the use of such flame retardants in furniture.
Fire Sprinklers: Supported favorable tax treatment to encourage the installation of automated sprinkler systems through 100% expensing and accelerated depreciation.
Health Care Policy, Coverage and Reimbursement Issues
Medicare and Medicaid Cuts to Hospitals that Threaten the Survival of Burn Centers: The ABA advocated over the years in opposition to several proposals that would have cut programs such as Medicare Support for Providers for Patients with Bad Debt, Medicaid and Medicare DSH payments, Medicare Updates and Medicare Graduate Medical Education and Indirect Medical Education Programs.
Annual and Lifetime Limits or Caps on Insurance Coverage: The ABA successfully advocated in favor of eliminating annual and lifetime caps on insurance coverage, which disproportionately impacted burn patients because of the high cost of treating major burn injuries.
Eliminating the 24-month Waiting Period for Medicare Eligibility for Disabling Burn Injuries: Under current law, a person suffering a disabling injury must wait 24-months to become eligible for Medicare. Exceptions are made for those suffering from end-stage renal disease and ALS. With our assistance, the ABA worked with the Congressional Budget Office to develop a revenue estimate for “disabling burn injuries,” and advocated for inclusion of such an exception in the Affordable Care Act. The Senate Finance Committee agreed with the ABA and initially proposed eliminating the 24-month waiting period completely. This provision was later dropped once universal health care coverage was mandated, thus accomplishing the ABA’s primary objective of ensuring that burn care patients could secure health care insurance coverage.
DRG Reform and Burn Care: The ABA worked with CMS to revise certain DRGs that impacted reimbursement for burn care procedures. After several years of discussions, CMS adopted and implemented the ABA’s recommendations to change these DRGs.
Quality Outcomes, Pay-for-Performance, and other Regulatory Issues: Worked with CMS on quality improvement programs such as BQIP, pay-for-performance, Preventable Hospital-Acquired Conditions and other matters.
Burn Care-specific Legislation
The Bioterrorism Act of 2002: The ABA successfully advocated for legislative language requiring State plans that provide for emergency medical services to include burn center care components.
The Children’s Access to Reconstructive Evaluation and Surgery (“CARES”) Act: As originally introduced, this legislation was intended to ensure insurance coverage for reconstructive procedures that otherwise might be deemed “cosmetic” and therefore uninsured. The CARES Act did not cover reconstructive surgery for burn injuries, but was subsequently amended to cover reconstructive procedures for burned children.
The Improving Trauma Care Act of 2014: Prior to the enactment of this legislation, federal law defined “trauma” as an injury resulting from the application of mechanical force, a definition which excluded burn injuries. This legislation redefined “trauma” to include burn injuries, which eliminates the need to secure the specific inclusion of “burns” every time legislation is introduced dealing with “trauma.” Consequently, when one now sees legislation such as the Joint Trauma and Education Directorate discussed below, even though the language uses “trauma,” it now by law also covers burns.
Trauma Care Systems Planning (“TCSP”) and Development Act: The ABA supported H.R. 648, which authorized funding so states could more effectively utilize scarce burn center resources, especially when responding to a mass casualty event. The legislation also included language requiring that any burn center participating in a state trauma plan or receiving finance assistance under the TCSP must meet the ABA’s verification standards. The House passed this legislation in 2015 by a margin of 382-15 but the Senate failed to take action.
Military Medical Treatment Facilities and Joint Trauma Education and Training Directorate: The National Defense Authorization Act of 2017 (“NDAA) included language calling for the Secretary of Defense to designate regional centers of excellence for specialized health care services, including “burn care.” The legislation also established a Joint Trauma Education and Training Directorate that is charged with ensuring that the Armed Forces is able to maintain readiness for its trauma and burn surgeons, coordinates the translation of research from the DOD’s centers of excellence into clinical trauma and burn care standards and much more. The ABA worked with the American College of Surgeons and other trauma organizations to secure inclusion of this language in the NDAA.