Rep. Mariannette Miller-Meeks

Maddy summaryHR 6344, the Simon Crosier Act, requires Medicare and Medicaid providers to establish written policies for do-not-resuscitate (DNR) orders involving unemancipated minors (under 18 without legal independence). It mandates that providers must inform at least one parent or legal guardian in person or by phone (with 72 hours of effort) before considering a DNR, allow parents/guardians to refuse consent, and prohibit overriding parental objections to life-sustaining treatment. The bill also requires providers to continue life-sustaining care for 15 days if a parent requests a transfer and explicitly prohibits using disability as the sole basis for DNR decisions. These requirements apply to all Medicare/Medicaid-covered facilities and directly affect minors, their parents, and healthcare providers.

Maddy summaryHR 6283, the DRUG Act, regulates pharmacy benefit managers (PBMs) to prevent practices that may increase prescription drug costs for consumers. The bill prohibits PBMs from earning revenue based on drug prices or discounts, requiring them to charge flat dollar service fees instead of fees tied to drug costs. It bans PBMs from steering patients to pharmacies they own or control, mandates equal reimbursement for affiliated and non-affiliated pharmacies, and prohibits charging different fees for the same drug. These provisions apply to group health plans, health insurance issuers, and PBMs, with enforcement beginning for plan years starting January 1, 2026. Violations would result in $10,000 daily penalties and require disgorgement of improperly received payments.

Maddy summaryThe Maximum Pressure Act (HR 6114) is a legislative proposal that would maintain and expand U.S. sanctions against Iran. The bill would codify existing sanctions, require Iran to meet 12 specific conditions before sanctions could be lifted (including ending support for terrorism, releasing hostages, and ending nuclear enrichment), and expand sanctions on Iran's Revolutionary Guard Corps and missile programs. It also establishes new reporting requirements for the U.S. government to monitor Iran's activities and the impact of sanctions. The legislation would require congressional review before any sanctions could be lifted or modified, preventing the executive branch from unilaterally easing restrictions.

Maddy summaryThis bill amends Medicare, Medicaid, and private insurance rules to improve coverage for drugs treating rare diseases (defined as conditions affecting 200,000 or fewer people in the U.S.). It requires coverage for rare disease drug uses supported by peer-reviewed medical literature and not listed as contraindicated in FDA labeling or medical reference guides. Private insurers must provide expedited review processes for denials of such drugs. The changes apply 30 days after enactment, affecting insurers and patients seeking coverage for rare disease treatments.

Maddy summaryThis bill, titled "Freezing HAMAS Act" (though it concerns Iran sanctions, not Hamas), reinstates U.S. sanctions on Iran that were previously waived or suspended under agreements with Iran. It specifically targets sanctions from the 2012 Iran Freedom and Counter-Proliferation Act and the 2012 National Defense Authorization Act, including a September 2023 waiver related to fund transfers. The bill prohibits the U.S. government from releasing funds or assets to Iran or granting further waivers related to these sanctions. It directly affects U.S. government actions regarding Iran financial transactions and enforcement of existing sanctions.

Maddy summaryHR 5840, the Transportation Security Screening Modernization Act of 2024, simplifies the process for transportation workers to obtain multiple TSA security credentials. It requires the TSA to allow individuals to apply for and renew programs like the TWIC (Transportation Worker Identification Credential) and HAZMAT Endorsement through a single enrollment at any TSA center, with a combined fee lower than separate applications. The bill mandates coordinated expiration dates for all credentials and ensures state-issued commercial driver's licenses reflect the correct HAZMAT endorsement validity. These changes aim to reduce duplication and costs for workers needing multiple security clearances. The TSA must implement these changes within two years and publish details online.

Maddy summaryThe DRA of 2023 adjusts Medicare payment rates for specific durable medical equipment (DME) items that were part of the 2021 competitive bidding program but for which no supplier contracts were finalized. It directly affects DME suppliers and Medicare beneficiaries by establishing a new 2024 payment formula: 90% of the adjusted payment amount plus 10% of the unadjusted fee schedule for eligible items. The bill also extends a temporary transition rule for non-rural areas through December 31, 2024, while delaying a regulatory change until 2025. These provisions aim to stabilize payments for DME items that did not transition to standard pricing under prior rules.

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 requires Medicare Part D drug plans (which cover seniors' prescription drugs) to include all cheaper generic drugs and at least two cheaper biosimilars in a "preferred" formulary position starting in 2024. Specifically, plans must list these lower-cost options on a tier with lower patient costs than the original brand-name drug, and cannot impose stricter access rules (like prior authorization) on them compared to the brand-name drug. It directly affects Medicare Part D sponsors and seniors enrolled in these plans by mandating more affordable drug options. The key change is requiring formulary placement and cost-sharing for specific lower-cost generics and biosimilars, without restricting patient access to them relative to brand-name alternatives.