Rep. Brett Guthrie

Maddy summaryThis bill requires Medicare to improve transparency in its national coverage decision process for medical treatments and devices. It mandates that Medicare (through the Secretary of Health and Human Services) must determine within 30 days if a submission is a complete request for a coverage decision, and if not, provide specific feedback on missing information. Complete requests must be posted publicly on a government website within two business days, and annual reports must include the time between submission and the point when the request was deemed complete. This directly affects healthcare providers, pharmaceutical companies, and medical device manufacturers seeking Medicare coverage for new treatments.

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.

Maddy summaryHR 4073, the Duty Drawback Clarification Act, clarifies U.S. tariff classifications for imported whiskies by creating specific subheadings in the Harmonized Tariff Schedule. It replaces a single tariff line with eight new subheadings that categorize whiskies by type (Irish/Scotch, Bourbon, Rye, or "Other") and container size (under or over 4 liters), each with a uniform duty rate of $2.04 per liter. This change directly affects whiskey importers and manufacturers who must now classify products using these new codes when entering goods into U.S. commerce. The bill streamlines duty calculation and drawback claims (refunds of duties on imported goods later exported) by standardizing the tariff structure for whiskey categories.

Maddy summaryHR 3561, the PATIENT Act of 2023, requires hospitals, health insurance plans, and pharmacy benefit managers to publicly disclose detailed pricing information for healthcare services and drugs. Hospitals must publish standard charges for 300+ shoppable services, including gross charges, payer-specific negotiated rates, and discounted cash prices, with updates required annually. Health plans must provide real-time information on in-network rates, cost sharing, deductibles, and prior authorization requirements for covered services. The bill establishes enforcement mechanisms, including civil monetary penalties for non-compliance, with fines ranging from $300 per day for small hospitals to $5 million for large hospitals that fail to comply with the transparency requirements.

Maddy summaryThe Pharmacy Benefits Manager Accountability Act requires pharmacy benefits managers (PBMs) and health insurance issuers to provide detailed annual reports to plan sponsors (like employers) about drug spending, rebates, and formulary decisions. These reports must include specific data on drugs dispensed, costs, patient out-of-pocket spending, rebates received from manufacturers, and net spending after rebates, all in machine-readable format. The bill establishes penalties of up to $10,000 per day for failure to provide required information and $100,000 per item for false information. It also directs a GAO study on pharmacy networks and common ownership structures to assess potential anti-competitive practices.

Maddy summaryThis bill amends the Social Security Act to exclude wages earned and self-employment income derived from unauthorized employment in the United States from being counted toward Social Security credits. It directly affects undocumented immigrants who work without authorization, preventing those earnings from contributing to their future Social Security benefits. The law changes existing Social Security rules by adding specific exclusions for "service performed by an alien while employed... not authorized to be so employed" and similar self-employment activities. These changes apply to all wages and income earned before, during, or after the bill's enactment, with Social Security recompiling existing benefit calculations to reflect the new rules.

Maddy summaryHR 497, the Freedom for Health Care Workers Act, eliminates a federal requirement for healthcare workers in Medicare and Medicaid programs to be vaccinated against COVID-19. The bill directly affects healthcare providers who treat patients under these federally funded programs by preventing the enforcement of the November 2021 HHS rule mandating staff vaccinations. Its key provision prohibits the Department of Health and Human Services from implementing, enforcing, or creating a similar rule regarding vaccination for these workers. This bill changes the policy by removing a specific vaccine mandate for providers in Medicare and Medicaid programs.

Maddy summaryThis bill extends a temporary COVID-19 emergency waiver that allows nurse aides in training to count hours worked during the pandemic toward their certification requirements at nursing facilities. It specifically permits these hours to satisfy the 75-hour minimum training requirement and allows facilities to conduct competency evaluations on-site if states don’t offer them weekly. The waiver remains in effect for at least 24 months after enactment, with a requirement for the Secretary to study its continued appropriateness within one year. The policy directly affects nurse aides working in skilled nursing facilities and nursing facilities under federal Medicare/Medicaid rules. It does not create new training programs but maintains pandemic-era flexibility for staffing.

Maddy summaryThis bill bans federal funding for abortions in most cases, prohibiting the use of taxpayer money for abortion services or health insurance plans covering abortion. Exceptions allow funding for abortions resulting from rape, incest, or when a pregnancy endangers a woman's life. It requires health insurance plans sold through the Affordable Care Act (ACA) marketplaces to clearly disclose any separate costs for abortion coverage and prohibits ACA subsidies from being used for plans that cover abortion (except in the specified exceptions). The law directly affects federal programs like Medicaid, ACA marketplace plans, and insurers offering health coverage to individuals using federal subsidies.

Maddy summaryHR 152, titled the "Hearing Protection Act," actually addresses firearm silencers (suppressors), not hearing protection. The bill removes federal registration requirements for silencers by directing the Attorney General to destroy all existing silencer records within 365 days. It also preempts state laws that tax, register, or impose recordkeeping requirements on silencers, making such state rules unenforceable. Additionally, the bill updates tax codes to include silencers as taxable items and clarifies their definition in firearm laws.