Rep. William R. Keating

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Maddy summaryHR 8796, the "Stop Comstock Act," removes outdated restrictions from federal law that previously banned the distribution of materials related to contraception and abortion as "obscene" or "indecent."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 summaryThe MEGOBARI Act directs the U.S. government to investigate and address democratic backsliding in Georgia. It requires reports within 90 days on Georgian corruption tied to Russian interests, sanctions evasion, and Russian intelligence assets, followed by potential sanctions against Georgian officials deemed responsible for undermining democracy or advancing Russian-style laws. The bill also establishes a U.S. democracy monitoring task force in Georgia and links additional U.S. aid - including trade negotiations, visa liberalization, economic packages, and defense support - to Georgia's progress toward fair elections and a free political environment. These provisions directly affect Georgia's government officials (who could face sanctions) and Georgia's eligibility for U.S. assistance. The bill does not impose new sanctions but mandates U.S. agencies to identify and sanction specific Georgian individuals under existing legal authorities.

Maddy summaryHR 7142 (Alternatives to PAIN Act) requires Medicare Part D plans to cover non-opioid pain management drugs with no deductible and at the lowest copay level starting in 2025. It defines "qualifying non-opioid drugs" as FDA-approved medications that don’t act on opioid receptors (like certain NSAIDs or nerve pain treatments), excluding opioids and schedule I-III drugs. The bill prohibits Medicare plans from forcing patients to try opioids first (step therapy) or requiring prior approval for these non-opioid options. It directly affects Medicare beneficiaries needing pain management, especially those seeking alternatives to opioids for post-surgical or acute pain. The policy change aims to improve access to non-addictive pain treatments while preserving doctors' authority to prescribe medically appropriate care.

Maddy summaryThe Medical Nutrition Equity Act of 2023 requires Medicare, Medicaid, CHIP, TRICARE, FEHBP, and private health insurance plans to cover medically necessary food for patients with specific digestive and inherited metabolic disorders. The bill defines "medically necessary food" as specialized formulas, vitamins, or amino acids prescribed by a physician for conditions including inherited metabolic disorders, malabsorption syndromes, food allergies, and inflammatory bowel diseases. It mandates coverage for both the food and necessary equipment/supplies to administer it, specifically prohibiting insurers from requiring feeding tubes when oral administration is possible. The bill also establishes that Medicare coverage will be 80% of the cost for these items. This legislation aims to ensure patients with these conditions can access the specialized nutrition therapies they need to prevent serious health complications like malnutrition, hospitalization, or developmental issues.

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 5663, the ALS Better Care Act, creates a new Medicare payment system to improve reimbursement for specialized care services provided to ALS patients. It establishes a $800 per visit payment rate starting in 2025 for qualified ALS care facilities, with annual increases based on market basket adjustments. The bill requires the Comptroller General to report on appropriate payment amounts and ensures this new payment is in addition to, not replacing, existing Medicare payments for ALS-related services. This aims to reduce wait times, support facilities in rural areas through telehealth access, and address funding challenges for ALS clinical trials.

Maddy summaryThe ORPHAN Cures Act amends the Drug Price Negotiation Program under the Social Security Act to clarify how orphan drugs (medications for rare diseases affecting fewer than 200,000 people in the U.S.) are treated. It ensures that periods when a drug was designated as an orphan drug are excluded from the time calculation used to determine when the drug can no longer be excluded from price negotiations. The bill also updates the definition to allow a single drug to be designated for multiple rare diseases, rather than just one. This change provides clearer rules for manufacturers and the government regarding orphan drug exclusions in the program.

Maddy summaryThis bill imposes U.S. sanctions on foreign individuals and entities that facilitate North Korea's transfer of arms or material support to Russia for use in Russia's invasion of Ukraine. It targets those responsible for such transfers, including foreign financial institutions enabling significant transactions related to these activities, requiring property blocks and visa restrictions. The bill also amends existing North Korea sanctions to explicitly require halting such material support and mandates the President to submit regular reports to Congress on North Korea's involvement and U.S. strategies to counter it.

Maddy summaryThe HANDS Act requires Medicare, Medicaid, and TRICARE to cover naloxone (an opioid overdose reversal drug) with no out-of-pocket costs when distributed by hospitals to patients identified as at-risk for overdose. It applies to individuals receiving care in hospital emergency departments, inpatient settings, or ambulatory surgical centers, specifically at the time of discharge or when leaving the facility. The bill mandates that providers must determine a patient's overdose risk before distributing naloxone, along with administration instructions. This policy change eliminates cost-sharing barriers for this specific naloxone distribution method, aiming to increase access for vulnerable patients.