Rep. Lori Trahan

Maddy summaryThis bill amends Medicare rules to ensure portable ultrasound services receive the same reimbursement treatment as portable X-ray services. It requires Medicare to provide separate payments for portable ultrasound transportation and setup services starting January 1, 2026, mirroring the current payment structure for portable X-ray services. The law directly affects Medicare beneficiaries needing these services and healthcare providers who supply them. Key provisions specify that payment requirements for ultrasound services must be substantially similar to existing regulations for portable X-ray suppliers under federal law.

Maddy summaryThis bill extends Medicare payment adjustments for physicians and other practitioners through 2025 instead of ending in 2024. It specifically adds a 4.73% payment increase for services provided between January 1, 2025, and January 1, 2026. The legislation modifies existing Medicare payment rules to stabilize practice revenues during transition periods. It directly affects doctors and healthcare providers who bill Medicare for patient services. The key change is the extended timeframe and the defined 4.73% rate for the 2025-2026 period.

Maddy summaryThis bill establishes a process for Medicare to set payment rates for certain pediatric medical devices used in children's care. Manufacturers of qualifying pediatric technologies (devices approved by the FDA, covered under Medicare, and designed specifically for children or used predominantly in pediatric procedures) can request the Secretary to create national payment rates under the physician fee schedule. The Secretary must then set these rates using available data like claims or pricing information, with specific deadlines for processing requests (by May 1 for same-year implementation). This affects Medicare payments for these devices but does not change coverage requirements or guarantee payment for new technologies.

Maddy summaryHR 8796, the "Stop Comstock Act," removes outdated restrictions from federal law that previously banned the distribution of materials related to contraception and abortion as "obscene" or "indecent." The bill amends Title 18 and the Tariff Act by deleting references to "indecent," "immoral," "unlawful abortion," and "procuring abortion" from provisions governing obscene materials. It clarifies that the law only prohibits "obscene materials" in commerce, eliminating broad restrictions on reproductive health information. This directly affects internet platforms, healthcare providers, and individuals sharing reproductive health resources by removing legal barriers to their distribution.

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 summaryHR 8390, the Mental Health and MAMA Act of 2024, eliminates cost-sharing (like copays or deductibles) for mental health and substance use disorder services during pregnancy and for one year after birth. It applies to people enrolled in group health plans, individual insurance, or federal employee health plans, covering services provided by in-network providers. The bill requires insurers to waive these costs starting two years after enactment, explicitly including telehealth services. It specifically targets care for pregnant and postpartum individuals, ensuring coverage from pregnancy diagnosis through the 12 months following birth.

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 (HR 7397) would define "essential health system" in federal law to specifically include certain hospitals serving high numbers of low-income patients. It targets non-Federal, non-profit hospitals that meet one of three criteria: having Medicaid disproportionate share status, serving at least 35% low-income Medicare patients, or receiving significant uncompensated care payments under Medicare. The definition applies to hospitals already designated under existing Medicaid and Medicare programs. This is a technical clarification to standardize how these hospitals are identified in federal statutes.

Maddy summaryThis bill, HR 6860, protects patients with end-stage kidney disease (ESRD) who require dialysis by preventing health insurance plans from discriminating against them. It amends Medicare rules to prohibit plans from treating dialysis coverage differently than other medical services based on a patient’s ESRD diagnosis, need for dialysis, or any other factor. The bill clarifies that plans can still choose which dialysis providers to include in their networks but cannot deny or limit coverage for dialysis services solely because of the patient’s condition. It ensures Medicare remains the secondary payer for these services as intended, without forcing plans to cover specific providers.

Maddy summaryHR 6780 establishes a 4-year Medicare demonstration program testing whether hospitals providing medically tailored home-delivered meals to specific patients improves health outcomes and reduces hospital readmissions. The program targets Medicare beneficiaries with diet-sensitive chronic conditions (like diabetes or heart failure) who are at high risk of readmission and meet specific discharge criteria, such as limited daily living activities. Selected hospitals must screen patients, provide at least two tailored meals daily for 12 weeks, and offer medical nutrition therapy, all without patient cost-sharing. The program requires hospitals to submit data for evaluation, with the goal of assessing impacts on hospital admissions, care costs, and patient satisfaction before reporting to Congress in 2027 and 2030.