Rep. Mariannette Miller-Meeks

Maddy summaryHR 3227, the Ensuring Seniors’ Access to Quality Care Act, amends Medicare and Medicaid rules to address nurse aide training programs in nursing facilities. It allows the Secretary of Health and Human Services to disapprove a facility’s nurse aide training program for up to two years if the facility received a $10,697+ civil penalty for substandard care and hasn’t corrected the quality issues. Facilities can have disapproval lifted by proving they fixed the care deficiencies, haven’t had recent patient harm incidents, and the penalty didn’t involve immediate patient jeopardy. The changes apply only to penalties assessed after the bill’s enactment and do not affect facilities already prohibited under prior rules.

Maddy summaryThis bill requires Medicare-participating clinical diagnostic labs to publicly disclose pricing for covered tests starting January 2025. Labs must post three specific prices online: the discounted cash price, minimum negotiated rate with insurers, and maximum negotiated rate for each test, including related services like specimen collection. The information must be updated annually and made accessible on a public website. This directly affects labs that serve Medicare patients, aiming to increase price transparency for consumers and insurers.

Maddy summaryThe PASTEUR Act establishes a new subscription payment model to incentivize development of new antimicrobial drugs for resistant infections. It creates a Committee on Critical Need Antimicrobials and a Subscription Contract Office to manage payments based on specific drug characteristics like treating multi-drug resistant infections, novel mechanisms of action, and oral administration. Under this model, the government would pay drug developers up to $3 billion over 10 years for qualifying drugs, with payments tied to requirements like ensuring drug availability, reporting resistance data, and developing appropriate use plans. The bill aims to address the lack of new antimicrobial drugs by changing the funding model to reward drugs that meet specific clinical and public health needs.

Maddy summaryThis bill regulates pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans. It prohibits PBMs from earning income based on drug prices or rebates (requiring flat fees instead), mandates equal reimbursement for all network pharmacies, and requires PBMs to report how much of drug rebates they pass through to Medicare plans. The law also mandates annual compliance certifications and requires the government to publish aggregated transparency data (without revealing specific plan details) starting in 2024. These changes directly affect Medicare Part D plans and the seniors who rely on them for prescription drug coverage.

Maddy summaryThe Pharmacy Benefit Manager Sunshine and Accountability Act requires Pharmacy Benefit Managers (PBMs) to publicly disclose detailed financial information about their contracts with drug manufacturers and health plans. Specifically, PBMs must report total rebates received, administrative fees collected, amounts retained (not passed through to health plans), and the retained rebate percentage for each contract. This data, including the highest and lowest retained rebate percentages across all contracts, must be submitted annually to the Department of Health and Human Services and published on a public website. The bill directly affects PBMs and the health plans/insurance issuers they serve by increasing transparency in how drug pricing and rebates are managed.

Maddy summaryHR 2667, the "Fighting Trade Cheats Act of 2023," increases penalties for importers who commit customs fraud or gross negligence. It triples civil penalties for fraudulent violations (to three times the domestic value) and raises gross negligence penalties to ten times, while adding five-year import bans for fraud and two-year bans for gross negligence. The bill also allows U.S. businesses, unions, or trade groups harmed by such violations to sue violators in federal court for triple damages, attorney fees, and injunctions against further imports. Additionally, it excludes violators and their affiliated companies from the Importer of Record program, with special rules to block shell companies evading customs laws. This directly affects importers who violate customs laws and U.S. businesses competing with those imports.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

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 modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

Maddy summaryThe HELLPP Act (HR 1634) amends Medicaid to recognize doctors of podiatric medicine (podiatrists) as physicians, enabling them to be reimbursed for services under Medicaid starting January 1, 2024. It also clarifies Medicare’s documentation requirements for therapeutic shoes for people with diabetes, mandating specific written certifications from a managing physician and a podiatrist to confirm medical necessity. These changes directly affect patients with foot conditions, especially those with diabetes, by improving access to podiatrist-provided care and coverage for therapeutic shoes. The bill includes a separate provision strengthening Medicaid program integrity through continuous levies on provider payments, but this does not alter patient coverage. All key provisions take effect on January 1, 2024.