Rep. Gus M. Bilirakis

Maddy summaryThis bill creates a special enrollment period for people with COBRA health coverage who become eligible for Medicare Part B. It allows them to enroll in Medicare during the time they're on COBRA plus a 3-month grace period afterward, but only once in their lifetime. The bill also prevents COBRA coverage from reducing or ending benefits just because someone is eligible for Medicare but hasn't enrolled yet. It affects individuals transitioning from employer-sponsored COBRA plans to Medicare, particularly those turning 65 or becoming Medicare-eligible. The changes take effect for COBRA coverage beginning January 1, 2025.

Maddy summaryThis bill establishes Medicare coverage for diabetes prevention program services to help prevent type 2 diabetes in at-risk beneficiaries. It defines these services as structured behavioral health sessions following a CDC-approved curriculum, available to Medicare beneficiaries who haven't been diagnosed with diabetes (other than gestational diabetes) and meet specific medical criteria. The bill creates a new payment structure for diabetes prevention program suppliers, requiring them to be recognized by the CDC and meet administrative requirements for tracking participant data and maintaining program standards. It also sets a transition deadline of January 1, 2025, for ending the previous Medicare Diabetes Prevention Program Expanded Model and requires a report on the program's impact by 2028.

Maddy summaryHR 7742, the At HOME Services Act, creates a 2-year Medicare demonstration program allowing hospitals to provide outpatient observation services to beneficiaries in their homes. It grants hospitals temporary exemptions from certain hospital requirements (like 24-hour on-site nursing and physical space standards) and expands telehealth access to home settings. Hospitals must maintain inpatient-level care standards, collect data on care quality and costs, and submit to a study comparing home-based care outcomes to traditional hospital care. The program will analyze factors like health outcomes, costs, patient experience, and demographic data before a final report is published.

Maddy summaryThis bill requires Medicare to cover falls risk assessments and fall prevention services during annual wellness visits and initial preventive physical exams for seniors aged 65+ who have fallen in the previous year. It directly affects Medicare beneficiaries with recent falls and healthcare providers delivering these services under Medicare. The key mechanism expands existing Medicare benefits to include these specific fall prevention services, effective January 1, 2025. Additionally, it mandates annual reports starting in 2026 tracking falls data for seniors over 65 who received fall-related treatment.

Maddy summaryThis bill requires Medicare to provide clear outreach and education so Medicare beneficiaries (enrolled in Part A, Part B, or Medicare Advantage plans) can authorize family caregivers to access their health information via 1-800-MEDICARE. It mandates the inclusion of a specific authorization form (CMS-10106) in Medicare notices and on Medicare.gov, along with training for call center staff. The Secretary must also share best practices to prevent fraud related to caregiver access and make materials available in non-English languages. It directly affects beneficiaries, their family caregivers, healthcare providers, and Medicare call center operators.

Maddy summaryThis bill clarifies that Medicare must cover fully implanted active middle ear hearing devices as prosthetics, not as hearing aids. It requires the Centers for Medicare & Medicaid Services (CMS) to update its rules within 60 days of the bill's enactment to remove these devices from Medicare's hearing aid coverage exclusion. This directly affects Medicare beneficiaries who rely on these specific implanted devices for hearing. The change means these devices will now be covered under Medicare's prosthetic benefits, not excluded under hearing aid rules, without altering existing coverage for other hearing aids.

Maddy summaryThis bill expands eligibility for certain tax-advantaged health accounts to cover medical expenses for parents. It amends the tax code to allow individuals to use funds from Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs) for qualified medical care of their parents or their spouse's parents - previously limited to immediate family members. The changes apply to expenses incurred after December 31, 2023, directly benefiting adult caregivers (like children supporting elderly parents) who use these accounts for parental healthcare costs. The bill makes no new funding commitments but adjusts existing account rules to reduce out-of-pocket costs for caregivers.

Maddy summaryHR 7142 (Alternatives to PAIN Act) requires Medicare Part D plans to cover non-opioid pain management drugs with no deductible and at the lowest copay level starting in 2025. It defines "qualifying non-opioid drugs" as FDA-approved medications that don’t act on opioid receptors (like certain NSAIDs or nerve pain treatments), excluding opioids and schedule I-III drugs. The bill prohibits Medicare plans from forcing patients to try opioids first (step therapy) or requiring prior approval for these non-opioid options. It directly affects Medicare beneficiaries needing pain management, especially those seeking alternatives to opioids for post-surgical or acute pain. The policy change aims to improve access to non-addictive pain treatments while preserving doctors' authority to prescribe medically appropriate care.

Maddy summaryHR 6790 establishes National Institutes of Health centers to advance research, early detection, and public awareness of rare kidney diseases, with a focus on rural and underserved communities. It mandates a federal study on genetic testing barriers, treatment patterns, and public awareness for rare kidney diseases affecting disproportionately impacted populations, including barriers to insurance coverage and access to specialists. The bill also funds nephrology training programs to increase specialists serving these communities and requires experiments to delay or prevent the need for dialysis and transplants. Total funding of $7 million is authorized for fiscal years 2024-2028 to support these research, education, and early intervention efforts.

Maddy summaryThis bill adds audiology services to Medicare's covered benefits under Section 1861(s)(2)(KK), effective January 1, 2025. It allows qualified audiologists to provide hearing and balance assessments and diagnostic/treatment services without requiring a physician referral or supervision, directly affecting Medicare beneficiaries seeking these services and audiologists practicing under state law. Payment will be 80% of the lower of actual charge or the Medicare fee schedule. The bill does not expand the types of audiology services covered but changes how they are accessed and paid for under Medicare.