Rep. Randy Feenstra

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 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.

Maddy summaryThe Veterans HSA Access Act of 2023 changes IRS rules to allow veterans who receive certain veterans benefits (like disability compensation) but do not have a service-connected disability to contribute to health savings accounts (HSAs). This removes a current barrier preventing these veterans from using HSAs to pay for qualified medical expenses. The policy change applies to tax years starting after December 31, 2025, meaning it will take effect in 2026. It directly affects veterans with non-service-connected health issues who currently cannot use HSAs despite qualifying for other veterans' benefits.

Maddy summaryThis bill, HR 5796, prohibits the Department of Health and Human Services from implementing a proposed rule requiring minimum staffing levels in nursing homes. It creates an advisory panel of 15 members - including rural nursing home staff and experts - to study workforce shortages and report on access barriers for seniors, especially in rural areas. The panel must submit an initial report within 60 days, analyzing staffing challenges and recommending solutions to strengthen the nursing home workforce. These provisions directly aim to prevent nursing home closures (like the 129 that occurred in 2022) that threaten rural seniors’ access to care.

Maddy summaryThis bill establishes an Agricultural Trade Enforcement Task Force to address foreign trade barriers harming U.S. agricultural exports, specifically targeting India's WTO-violating price support programs for rice, wheat, and other commodities. The Task Force, led by the U.S. Trade Representative and Agriculture Department, must identify systemic trade barriers, develop enforcement strategies, and file a WTO dispute against India within 60 days of consultations if needed. It requires quarterly reports to Congress on progress, including a specific plan to challenge India's subsidies that exceed WTO limits (e.g., rice supports at 93.9% of production value). The bill directly affects U.S. farmers, ranchers, and exporters who face market access barriers due to these foreign subsidies.

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 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 Breast Cancer Patient Equity Act would require Medicare to cover custom-made breast prostheses for women who have undergone mastectomies, directly affecting Medicare beneficiaries and influencing private insurance coverage practices. Currently, Medicare denies coverage for these prostheses as "not medically necessary" while covering surgical breast reconstruction, creating a gap that disproportionately impacts older and minority women. The bill amends Medicare’s coverage rules to explicitly include custom breast prostheses under the same category as other body part prostheses. This change would address the lack of access to a common, less invasive alternative to surgery for over 100,000 women undergoing mastectomies annually.

Maddy summaryHR 3748, the SAFE Act of 2023, requires U.S. agricultural agencies to proactively negotiate trade agreements with foreign governments to minimize export disruptions caused by animal disease outbreaks. It directs the Secretary of Agriculture, in coordination with the U.S. Trade Representative, to establish regionalization, zoning, or compartmentalization agreements with key export markets for U.S. livestock and animal products. The bill also mandates that the Food Safety and Inspection Service notify state agricultural departments and producer groups within three days if export-related information is removed from official libraries. This directly affects livestock producers and exporters by aiming to stabilize access to international markets during disease events. The law amends the Animal Health Protection Act to formalize these negotiation and notification requirements.

Maddy summaryHR 3739, the FAIR TARIFF Act of 2023, requires U.S. Customs to refund overpaid duties for specific imports from European Union countries during two defined periods: October 18-December 17, 2019, and January 12-February 10, 2022. It targets products classified under certain Harmonized Tariff Schedule codes (e.g., 9903.89.10-9903.89.49 for 2019, 9903.89.57-9903.89.59 for 2022) that were incorrectly taxed due to tariff misclassification. Importers must apply for refunds within one year of the law’s enactment, with refunds processed within 180 days of application. The bill also mandates a 60-day advance notice in the Federal Register before implementing new tariff increases under Section 301 of the Trade Act of 1974.