Rep. Kevin Hern

Maddy summaryThis bill amends tax code rules to allow married individuals to contribute to their own health flexible spending account (FSA) even if their spouse already has an FSA. It permits these contributions provided the combined reimbursements for both spouses do not exceed the total eligible expenses that would apply if the spouse's account didn't exist. The change applies to health savings plans starting in 2024, affecting married taxpayers with dual FSA coverage. It clarifies the reimbursement limits without creating new benefits or altering existing FSA structures.

Maddy summaryThe ORPHAN Cures Act amends the Drug Price Negotiation Program under the Social Security Act to clarify how orphan drugs (medications for rare diseases affecting fewer than 200,000 people in the U.S.) are treated. It ensures that periods when a drug was designated as an orphan drug are excluded from the time calculation used to determine when the drug can no longer be excluded from price negotiations. The bill also updates the definition to allow a single drug to be designated for multiple rare diseases, rather than just one. This change provides clearer rules for manufacturers and the government regarding orphan drug exclusions in the program.

Maddy summaryThe Maintaining Investments in New Innovation Act (HR 5547) extends the exclusivity period for certain advanced drugs from 7 to 11 years. It defines an "advanced drug product" as a drug using genetically targeted technology to change how genes work, such as drugs that suppress or activate gene function. The bill amends the Social Security Act to update the definition of "qualifying single source drug" to include these advanced therapies with the longer exclusivity period. This change directly affects drug manufacturers developing such advanced therapies and influences Medicare's drug coverage rules by delaying generic competition for these specific treatments.

Maddy summaryThis bill clarifies that Medicare must cover external infusion pumps and associated non-self-administrable drugs as durable medical equipment (DME) when specific criteria are met. It directly affects Medicare beneficiaries requiring home infusion therapy for drugs that must be prepared just before use, administered by a healthcare professional, or labeled for external pump use at least monthly. Key provisions require the drug's FDA labeling to specify external pump administration, safe home delivery by qualified suppliers, and preparation/administration requirements. The bill mandates Medicare coverage under existing rules (LCD L33794) for qualifying treatments, effective upon enactment or FDA approval, whichever is later.

Maddy summaryThis bill allows employees to directly transfer funds from a health flexible spending account (FSA) or health reimbursement arrangement (HRA) to a health savings account (HSA) when switching to a high-deductible health plan after a gap in coverage. It sets a dollar limit on these transfers based on annual HSA contribution rules and requires the transfer to occur after a significant period without coverage. Employers must report these transfers on employees' W-2 forms. The changes apply to distributions made after December 31, 2023.

Maddy summaryThis bill amends the Affordable Care Act and Medicaid/CHIP programs to deny health insurance subsidies, coverage, and related benefits to individuals with Deferred Action for Childhood Arrivals (DACA) status. Specifically, it excludes people lawfully present only due to the 2012 DHS memo granting deferred action from eligibility for ACA subsidies, Medicaid, and the State Children's Health Insurance Program (CHIP). The bill requires states to remove DACA recipients from enrollment in health plans and rescind any existing waivers that allowed such coverage. It directly affects approximately 800,000 DACA recipients who currently qualify for ACA subsidies and Medicaid/CHIP under existing rules.

Maddy summaryHR 3417, the FAIR Act, requires hospitals with off-campus outpatient departments (OCODs) to use separate unique health identifiers for those departments by January 1, 2025. It mandates that these departments bill Medicare and other insurers using specific formats (HIPAA X12 837P or CMS 1500) with their unique identifier, rather than billing under individual practitioners. This directly affects hospitals operating OCODs, changing how they submit claims for services provided at those locations. The bill takes effect for claims submitted on or after January 1, 2025, ensuring clearer billing accountability for these departments.

Maddy summaryHR 3095, the "Address Iran’s Malign Posture Act," expands U.S. sanctions to target foreign entities providing financial services, material support, or acting on behalf of Iran’s Revolutionary Guard Corps or designated terrorist groups. It requires the President to block all U.S. financial transactions with these entities and mandates that any nuclear agreement with Iran must be approved by a two-thirds vote in the Senate as a treaty. The bill also sets a 2025 sunset date for these sanctions provisions and related waivers. This directly affects foreign banks, businesses, and individuals engaging in transactions with Iran’s military or terror-linked entities.

Maddy summaryThis bill would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.

Maddy summaryThis bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.