Maddy summaryHR 5819, the COMPLETE Care Act, incentivizes Medicare primary care providers to integrate behavioral health services by increasing payments for specific services (like mental health and substance use disorder support) during 2025-2027. Providers using designated HCPCS codes for integrated care would receive 125-175% of standard payment rates, with the percentage declining annually. The bill also requires these providers to report on integration quality measures and mandates technical assistance for practices adopting integrated models, funded through new appropriations for 2024-2027. It directly affects Medicare-participating primary care practices serving beneficiaries needing mental health or substance use services.
Rep. Brittany Pettersen
Sponsored bills
Maddy summaryThe End Diaper Need Act of 2023 creates a federal program that will provide free diapers and incontinence supplies to low-income families with infants, toddlers, medically complex children (3+ years old with chronic health conditions), and low-income adults with disabilities. It allocates $200 million annually from 2024-2027 to fund this assistance through states and community organizations, making medically necessary diapers eligible for reimbursement through health savings accounts and other health benefit programs. The legislation requires integration with existing services like Medicaid, WIC, and TANF, and includes annual reporting requirements and an evaluation of the program's effectiveness within two years.
Maddy summaryHR 5663, the ALS Better Care Act, creates a new Medicare payment system to improve reimbursement for specialized care services provided to ALS patients. It establishes a $800 per visit payment rate starting in 2025 for qualified ALS care facilities, with annual increases based on market basket adjustments. The bill requires the Comptroller General to report on appropriate payment amounts and ensures this new payment is in addition to, not replacing, existing Medicare payments for ALS-related services. This aims to reduce wait times, support facilities in rural areas through telehealth access, and address funding challenges for ALS clinical trials.
Maddy summaryThe HANDS Act requires Medicare, Medicaid, and TRICARE to cover naloxone (an opioid overdose reversal drug) with no out-of-pocket costs when distributed by hospitals to patients identified as at-risk for overdose. It applies to individuals receiving care in hospital emergency departments, inpatient settings, or ambulatory surgical centers, specifically at the time of discharge or when leaving the facility. The bill mandates that providers must determine a patient's overdose risk before distributing naloxone, along with administration instructions. This policy change eliminates cost-sharing barriers for this specific naloxone distribution method, aiming to increase access for vulnerable patients.
Maddy summaryThe Cutting Copays Act lowers prescription drug costs for low-income Medicare Part D beneficiaries. Starting in 2024, generic drugs will have a $0 copay, while other drugs will have a copay set at the 2023 level (adjusted for prior changes) and then increased annually by the consumer price index. For 2023 and earlier, the maximum copay for generic drugs was $1 and for other drugs was $3. This directly reduces out-of-pocket expenses for millions of low-income seniors and people with disabilities enrolled in Medicare Part D.
Maddy summaryThis bill changes Medicare payment rules for anesthesiologist services in specific rural hospitals. It requires Medicare to pay for anesthesiologist services in qualifying rural hospitals using the same "reasonable cost, pass-through" reimbursement method currently used for certified registered nurse anesthetists (CRNAs), rather than the standard physician payment rate. The bill directly affects rural hospitals and anesthesiologists working in those facilities, ensuring they receive comparable reimbursement to CRNAs under existing rules. The change applies to services provided during cost reporting periods starting after the bill's enactment date. This is a technical adjustment to payment methodology, not a new coverage benefit.
Maddy summaryThe Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.
Maddy summaryThis bill, the Public Servants Protection and Fairness Act of 2023, amends Social Security to better protect public servants who work in jobs not covered by Social Security (such as certain government positions). It creates a new formula for calculating retirement benefits that combines both covered and noncovered earnings, ensuring public servants receive the higher of two benefit calculations. The bill also provides an additional $150 monthly payment for certain public servants whose benefits were previously reduced by the windfall elimination provision. It improves Social Security account statements to clearly show noncovered earnings and requires a study of how state retirement plans handle these benefits. These changes will apply to benefits starting in 2025.
Maddy summaryHR 3875, the Expanded Telehealth Access Act, expands Medicare coverage for telehealth services by adding new healthcare professionals to the list of providers eligible for payment. It specifically includes licensed audiologists, occupational therapists (and their assistants under supervision), physical therapists (and their assistants under supervision), and speech-language pathologists. The bill ensures these providers are paid the same rate for telehealth services as they would be for in-person care under Medicare. This change directly affects Medicare beneficiaries seeking remote therapy services and the new provider types who can now offer these services via telehealth.
Maddy summaryThe Menstrual Equity For All Act of 2023 requires free menstrual products to be available at no cost in public schools, colleges, correctional facilities, and federal buildings. It makes menstrual products covered by Medicaid, prohibits taxes on these products, and provides funding through social services programs to help low-income individuals access menstrual products. The bill directly affects students (K-12 and college), incarcerated people, homeless individuals, employees (in businesses with 100+ workers), Medicaid beneficiaries, and people receiving Temporary Assistance for Needy Families (TANF). Key provisions include amending school funding to require free products, creating college grant programs for menstrual product distribution, and adding menstrual products to Medicaid coverage and social services programs.