Rep. Mike Bost

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.

Maddy summaryThe Essential Caregivers Act of 2024 requires nursing homes and similar facilities to allow residents to designate essential caregivers who provide emotional support or assistance with daily activities. During emergencies when regular visitation is restricted, facilities must permit at least one essential caregiver access to residents daily and cannot deny access without following specific procedures. Facilities may deny access for a maximum of 7 days during emergencies (or 14 days with state approval), and must provide a written explanation and appeal process if access is denied. The bill establishes a 48-hour appeal process for residents and caregivers to challenge denials, with facilities required to prove violations during appeals. This law applies to Medicare skilled nursing facilities, Medicaid nursing facilities, intermediate care facilities, and certain inpatient rehabilitation facilities.

Maddy summaryThis bill would require the U.S. to reimpose tariffs on steel imports from Mexico that were in effect before May 2019. The tariffs must remain in place for at least one year, and the U.S. Trade Representative and Commerce Secretary must certify that Mexico has fixed its trade practices before lifting them. The President may also add import limits to return steel imports from Mexico to pre-2019 trade levels. The bill directly affects Mexican steel exporters and aims to address claims that Mexico violated a 2019 trade agreement.

Maddy summaryThe Preserving Seniors’ Access to Physicians Act of 2023 increases the Medicare payment adjustment rate for physicians from 1.25% to 4.62%, directly affecting doctors who treat Medicare patients (primarily seniors). It also reduces the funding for the Medicaid improvement fund from $5,796,117,810 to $3,973,117,810. These changes impact Medicare providers and Medicaid programs, with the Medicare adjustment aimed at supporting physicians adjusting to payment changes. The bill does not specify how the Medicaid funding reduction relates to its stated goal of preserving seniors' access to physicians.

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 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 5912 (PUNISH Act of 2023) maintains existing U.S. sanctions against Iran by preventing the President from lifting them without new certification. It requires the State Department to submit every 180 days a report confirming Iran has not engaged in targeted violence (such as assassinations of U.S. citizens, Iranian residents in the U.S., or politically motivated abuse) over the past five years. This certification must be provided before sanctions can be waived, suspended, or reduced under current laws like the Iran Sanctions Act. The bill directly affects the President’s authority to ease sanctions, Iranian entities subject to existing sanctions, and U.S. agencies responsible for reporting. It does not create new sanctions but extends the duration of current measures until a specific certification date.

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 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 prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.