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Comment from Texas Appleseed on Department of Health and Human Services Proposed Rule (CMS-3342-P) for Medicare and Medicaid Programs: Revision of Requirements for Long-Term Care Facilities: Arbitration Agreements. Excerpt from Comment: Given the reality of subpar care at nursing homes across the country, a decreasing enforcement budget, the flaws inherent to the arbitration system outlined in this comment, and the ability of lawsuits, including class actions, to remedy harms and incentivize better practices, Texas Appleseed supports ensuring access to the court system is available to consumers by preventing pre-dispute arbitration agreements in the context of nursing homes.