Rep. John Joyce

Unauthorized Spending Accountability Act of 2021 This bill establishes a three-year budgetary level reduction schedule for unauthorized programs funded through the annual appropriations process. Under the bill, a budgetary level is an allocation provided to the congressional appropriations committees under Section 302(a) of the Congressional Budget Act of 1974 by a congressional budget resolution or a deeming resolution. The schedule applies to programs included in the Congressional Budget Office's annual report listing programs that are funded through the appropriations process and have an authorization of appropriations that has either expired or will expire during the year. For the first year after a program's authorization has expired, the bill requires the budgetary level to be reduced by 10% of the funds appropriated for the program in the expiring fiscal year. The bill then requires reductions of 15% in the second and third years before terminating the program at the end of the third unauthorized year. Programs that are reauthorized during the three-year period are exempt from the budgetary level reductions if the reauthorization contains a sunset provision limiting the authorization of appropriations period to no more than three years. The bill establishes the Spending and Accountability Commission to review all mandatory spending programs and submit to Congress a legislative proposal to establish an authorization cycle for discretionary spending programs. The commission may recommend legislation to replace the budgetary level reductions required by this bill with reductions in mandatory spending. The commission's reauthorization schedule must limit reauthorizations to three years, include the budgetary level reductions established by this bill, and establish a mechanism for replacing the budgetary level reductions with reductions to mandatory spending programs. The House of Representatives must consider the commission's proposal using specified expedited legislative procedures.

Medicare Orthotics and Prosthetics Patient-Centered Care Act This bill revises payment rules and establishes several requirements relating to coverage of orthotics and prosthetics under Medicare. Specifically, the bill requires suppliers of orthotics and prosthetics to meet certain standards with respect to licensure and accreditation, physical facilities, and liability insurance. Orthotists and prosthetists may also issue written orders for commercial purposes that meet specified standards; such orders must be signed by the treating physician. The bill also prohibits payment under Medicare for certain prosthetics and orthotics that are delivered via drop shipment (i.e., direct shipment to a beneficiary who has not received corresponding patient care from a health care practitioner).

Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021 This bill provides for Medicare coverage and payment for multi-cancer early detection screening tests that are approved by the Food and Drug Administration and that are used to screen for cancer across many cancer types.

This bill directs the Speaker of the House and the President pro tempore of the Senate to arrange for the award of three Congressional Gold Medals to the U.S. Capitol Police (USCP) and other law enforcement agencies that protected the U.S. Capitol on January 6, 2021. Following the award of these medals, one medal shall be given to the USCP, one medal shall be given to the Metropolitan Police Department of the District of Columbia, and one medal shall be given to the Smithsonian Institution and displayed with a plaque listing all law enforcement agencies that participated in protecting the Capitol on January 6, 2021.

Developing Responsible Individuals for a Vibrant Economy Act or the DRIVE-SAFE Act This bill directs the Department of Transportation to promulgate regulations to implement an apprenticeship program for licensed commercial motor vehicle drivers under the age of 21. Under the program, an apprentice must complete two probationary periods that total 400 hours of on-duty time, of which at least 240 hours must be driving time in a commercial motor vehicle. Additionally, the apprentice must be accompanied in the cab of the commercial motor vehicle by an experienced driver. Further, the bill requires all commercial motor vehicles used in the program for training to be equipped with safety technology such as active braking collision mitigation systems and video event capturing systems. An employer shall not knowingly allow, require, permit, or authorize a driver under the age of 21 to operate a commercial motor vehicle unless the driver is participating in, or has completed, an apprenticeship program that meets the requirements set forth in this bill.

Speeding Therapy Access Today Act of 2021 This bill requires and authorizes various actions to accelerate the development of therapies for rare diseases. The Food and Drug Administration (FDA) shall establish the Intercenter Institute on Rare Diseases and Conditions. The institute shall (1) coordinate engagement with relevant stakeholders, (2) build the FDA's expertise in the review of medical products to treat rare diseases, (3) coordinate regulatory science initiatives related to rare diseases, (4) establish and implement a program to make recommendations to address challenges associated with developing medical products to treat rare diseases in an individual or in very small populations, (5) convene a stakeholder meeting to consider potential amendments to labels for medical products to treat rare diseases, and (6) establish and carry out a program to facilitate voluntary communication between the sponsors of such medical products and third-party payers (e.g., insurance companies). The bill also authorizes the FDA to make grants to assist in developing practices related to the development and production of individualized therapies or therapies to treat very small populations. The bill also establishes an advisory committee to advise the FDA on issues related to the development of therapies to treat rare diseases.

Fair Access to Banking Act This bill restricts certain banks, credit unions, and payment card networks from refusing to do business with a person who is in compliance with the law. Restrictions include prohibiting the use of certain lending programs, initiating the process of terminating an institution's depository insurance, and instituting specified civil penalties.

TRICARE Reserve Select Improvement Act This bill expands TRICARE Reserve Select eligibility to include members of the Selected Reserve who are enrolled or eligible to enroll in the Federal Employees Health Benefits Program.

Death Tax Repeal Act This bill repeals the estate and generation-skipping transfer taxes. It also makes conforming amendments related to the gift tax.

Treatment and Relief through Emerging and Accessible Therapy for PTSD Act or the TREAT PTSD Act This bill requires the Department of Veterans Affairs (VA) and the Department of Defense (DOD) to furnish stellate ganglion block to certain veterans or members of the Armed Forces (including reserve components) diagnosed with post-traumatic stress disorder (PTSD). Blocking the stellate ganglion (a group of nerves at the base of the neck) by injecting a local anesthetic is a treatment that may alleviate PTSD symptoms. The bill authorizes this treatment for any veteran or member of the Armed Forces who (1) is enrolled in the VA health care system or TRICARE program, (2) has been diagnosed with PTSD, and (3) has elected to receive stellate ganglion block after being informed by a physician of the risks and benefits. Such treatment may be furnished at a VA medical center, DOD medical facility, or through health care provider under the Veterans Community Care Program or TRICARE health insurance program. The bill also requires the VA and DOD to update the VA/DOD Clinical Practice Guideline (CPG) for the Management of PTSD to ensure that information about stellate ganglion block is included.