Rep. Darin LaHood

Maddy summaryThis bill simplifies participation in Medicare's Accountable Care Organization (ACO) program by removing distinctions between small and large ACOs and eliminating the requirement for new ACOs to assume financial risk for three years before joining shared savings models. It creates a new "100% shared savings" option where ACOs keep all savings from cost reductions but bear full financial responsibility for losses. The bill also mandates clearer, transparent benchmark calculations for ACO performance, establishes appeal processes for disputed benchmarks, and requires technical assistance for rural and underserved providers. These changes directly affect Medicare ACOs, particularly smaller or newer organizations in rural or safety-net settings, aiming to make value-based care participation more accessible.

Maddy summaryHR 4794, the Dietary Supplements Access Act, allows health savings accounts (HSAs), flexible spending accounts (FSAs), and health reimbursement arrangements (HRAs) to cover dietary supplements as qualified medical expenses. The bill amends the Internal Revenue Code to treat payments for dietary supplements - defined under federal law (21 U.S.C. 321(ff)) - as medical care, directly affecting individuals using these accounts to pay for supplements like vitamins or minerals. Key provisions require HSAs, FSAs, and HRAs to reimburse supplement costs under the same rules as other medical expenses. The change applies to taxable years beginning after the bill’s enactment.

Maddy summaryHR 4752 (the CHANGE Act of 2023) requires Medicare to include standardized cognitive impairment screening during annual wellness visits and initial preventive physical exams for beneficiaries starting in 2024. It mandates doctors use National Institute on Aging-approved tools to detect memory issues and document results in medical records. This directly affects Medicare patients aged 65+ and their healthcare providers, aiming to enable earlier Alzheimer’s diagnosis and care planning. The bill focuses on making routine screenings a standard part of Medicare-covered checkups, not on funding or new programs. It does not alter existing Medicare benefits but adds a specific screening requirement to two existing service categories.

Maddy summaryThis bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.

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.

Maddy summaryThis bill grants the President new authority to negotiate a comprehensive trade agreement with the United Kingdom to reduce tariffs and other trade barriers. It requires negotiations to begin within 180 days of enactment and sets a March 1, 2025 deadline for finalizing an agreement. The bill includes specific limits on tariff reductions, preventing cuts below 50% of current rates for most goods or below Uruguay Round levels for agricultural products. This would directly affect U.S. businesses, farmers, and consumers by potentially lowering import costs and expanding market access for U.S. exports.

Maddy summaryHR 3611, the Kazakhstan Permanent Normal Trade Relations Act of 2023, makes Kazakhstan's existing "normal trade relations" (NTR) status permanent by removing the need for annual U.S. presidential reviews under the Trade Act of 1974. This bill directly affects U.S. trade policy with Kazakhstan, ending the requirement for the President to annually determine whether Kazakhstan meets emigration freedom standards (which it has satisfied since 1997). The key provision allows the President to formally extend permanent NTR treatment to Kazakhstan's products, eliminating the current annual review process. Once enacted, Kazakhstan would automatically receive the same most-favored-nation tariff rates as other NTR countries, streamlining trade without further congressional action.

Maddy summaryThis bill changes tax rules to treat direct primary care (DPC) membership fees as deductible medical expenses. It defines DPC as a fixed monthly fee (capped at $150 per person, $300 for families) for primary care services only, excluding procedures requiring anesthesia, prescription drugs (except vaccines), or lab tests. The law ensures these fees can be claimed on tax returns like other medical costs, while clarifying DPC arrangements aren’t considered health insurance plans. It applies to fees paid for DPC services provided through employment or directly to patients, effective for 2024 tax years.

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.