Rep. Jake Auchincloss

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 summaryThe Pharmacists Fight Back Act (HR 9096) sets new rules for Pharmacy Benefits Managers (PBMs) working with federal health care programs like Medicare Part D and Medicaid. It requires PBMs to reimburse in-network pharmacies at a rate covering the drug's actual cost plus a small fee (capped at $25), and to reduce patient cost-sharing by at least 80% of rebates received from drug manufacturers. The bill bans PBMs from steering patients to specific pharmacies, charging patients more than pharmacies are paid, or using rebates to lower pharmacy payments after claims are processed. It also mandates public reporting of drug pricing data to improve transparency, ensuring patients and pharmacies receive fairer treatment under federal health programs.

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 6283, the DRUG Act, regulates pharmacy benefit managers (PBMs) to prevent practices that may increase prescription drug costs for consumers. The bill prohibits PBMs from earning revenue based on drug prices or discounts, requiring them to charge flat dollar service fees instead of fees tied to drug costs. It bans PBMs from steering patients to pharmacies they own or control, mandates equal reimbursement for affiliated and non-affiliated pharmacies, and prohibits charging different fees for the same drug. These provisions apply to group health plans, health insurance issuers, and PBMs, with enforcement beginning for plan years starting January 1, 2026. Violations would result in $10,000 daily penalties and require disgorgement of improperly received payments.

Maddy summaryThis bill amends Medicare, Medicaid, and private insurance rules to improve coverage for drugs treating rare diseases (defined as conditions affecting 200,000 or fewer people in the U.S.). It requires coverage for rare disease drug uses supported by peer-reviewed medical literature and not listed as contraindicated in FDA labeling or medical reference guides. Private insurers must provide expedited review processes for denials of such drugs. The changes apply 30 days after enactment, affecting insurers and patients seeking coverage for rare disease treatments.

Maddy summaryHR 5400, the NO PBMs Act, requires Medicare Part D prescription drug plans (PDP sponsors) and pharmacy benefit managers (PBMs) to allow any pharmacy meeting basic contract terms to join their networks. This directly affects Medicare beneficiaries by expanding their choice of pharmacies, as current networks often restrict access to specific locations. Key provisions mandate that PDP sponsors and PBMs must accept all eligible pharmacies and establish standardized "reasonable and relevant" contract terms by January 1, 2026. The bill aims to increase pharmacy access without altering drug pricing or plan benefits.

Maddy summaryThe Social Security 2100 Act would significantly enhance Social Security benefits for millions of Americans by increasing monthly payments for retirees, disabled workers, widows/widowers, and children. Key provisions include raising the minimum benefit for long-term low earners, improving cost-of-living adjustments using a more accurate index, eliminating the 5-month waiting period for disability benefits, and extending child benefits to age 26. The bill also changes how Social Security taxes are calculated by applying them to income above $400,000 and establishes a unified Social Security Trust Fund to manage program finances. Most provisions would apply to benefits payable from 2025 through 2034, affecting all current and future Social Security beneficiaries.

Maddy summaryThis bill strengthens the U.S. law preventing imports made with forced labor from Xinjiang by expanding definitions of forced labor programs to include specific Chinese government initiatives like "surplus labor transfer," "Xinjiang Aid," and "re-education programs." It requires the U.S. government to update its strategy to align with U.S. Customs determinations about goods from Xinjiang and mandates detailed public lists of entities recruiting, transporting, or receiving forced labor outside Xinjiang. The law directly affects U.S. importers who must verify supply chains and Chinese entities operating labor programs in Xinjiang. Key provisions include broadening the scope of "forced labor" to cover state-imposed programs targeting Uyghurs and other minorities, and requiring transparency about entities linked to these programs.

Maddy summaryThe BLUE Pacific Act establishes a comprehensive U.S. strategy to deepen engagement with Pacific Island nations through coordinated assistance across multiple policy areas. It authorizes $250 million annually for fiscal years 2023-2033 to support initiatives in climate resilience, economic development, security capacity building, public health, and democratic governance. The act requires the President to develop a Pacific Islands Partnership Strategy by 2027, with regular congressional reporting, and mandates consultation with Pacific Island nations and regional organizations. This legislation formalizes U.S. efforts to support Pacific Island countries in addressing shared challenges like climate change, economic development, and security while strengthening regional partnerships. The strategy will guide U.S. assistance across multiple agencies to support Pacific Island nations' priorities as outlined in regional frameworks like the 2050 Strategy for the Blue Pacific Continent.

Maddy summaryThis bill expands access to lung cancer screening by requiring Medicaid, Medicare, and private insurance plans to cover annual screenings without cost-sharing or prior authorization for individuals meeting U.S. Preventive Services Task Force guidelines. It also removes pregnancy-based restrictions on tobacco cessation services, extending coverage for counseling and medications to all Medicaid enrollees. The law applies to all Medicaid beneficiaries, Medicare participants, and private insurance plans starting January 2024, eliminating barriers like co-pays or pre-approval for recommended screenings. Additional provisions include $10 million annually for public education campaigns and a federal study on under-screened lung cancer demographics.