Rep. Emanuel Cleaver

Maddy summaryHR 3086, the "Find It Early Act," requires health insurance plans to cover breast cancer screenings with no cost-sharing for certain individuals at higher risk of breast cancer. The bill affects people with increased risk (based on medical criteria or dense breast tissue) or those needing screening due to factors like age, race, ethnicity, or family history. Key provisions mandate coverage for 2D/3D mammograms, ultrasounds, MRI, and other technologies without frequency limits for these groups. This applies to group health plans, Medicare, Medicaid, TRICARE, and VA healthcare systems starting January 1, 2024. The law aims to improve early detection by removing financial barriers to necessary screenings.

Maddy summaryThis bill regulates pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans. It prohibits PBMs from earning income based on drug prices or rebates (requiring flat fees instead), mandates equal reimbursement for all network pharmacies, and requires PBMs to report how much of drug rebates they pass through to Medicare plans. The law also mandates annual compliance certifications and requires the government to publish aggregated transparency data (without revealing specific plan details) starting in 2024. These changes directly affect Medicare Part D plans and the seniors who rely on them for prescription drug coverage.

Maddy summaryThis bill establishes a new workplace violence prevention standard for healthcare and social service workers. It requires employers in covered facilities - including hospitals, nursing homes, mental health clinics, and social service settings - to develop and implement comprehensive prevention plans with specific requirements. These plans must include risk assessments, hazard prevention measures, employee training on violence prevention, and procedures for reporting and investigating violent incidents. The bill also amends Medicare regulations to require compliance with these standards for hospitals and skilled nursing facilities receiving Medicare funds.

Maddy summaryThe PROTECT 340B Act of 2023 prohibits pharmacy benefit managers (PBMs), health insurance plans, and health insurance issuers from discriminating against healthcare providers participating in the 340B drug pricing program. It specifically bans these entities from paying less for 340B drugs than they would for similar drugs dispensed by non-340B providers, imposing special requirements on 340B providers, or requiring identification of 340B drugs in billing. The bill establishes civil penalties of up to $5,000 per violation per day for PBMs that violate these protections and requires the Health Resources and Services Administration to create implementing regulations. It directly affects safety-net hospitals, clinics, and health centers that serve low-income patients, particularly those in rural areas, by protecting their ability to use 340B drug discounts to provide affordable care.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

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.

Maddy summaryThis bill modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

Maddy summaryThe E-BIKE Act establishes a 30% tax credit for individuals purchasing qualified electric bicycles, with a maximum credit of $1,500 per bicycle (30% of the $5,000 cost limit). To qualify, bicycles must meet specific safety standards including speed limits (20 mph for classes 1-2, 28 mph for class 3), pedal assistance requirements, and safety certifications like UL 2849. The credit phases out for higher-income taxpayers, beginning at $150,000 modified adjusted gross income for single filers, $225,000 for heads of household, and $300,000 for joint filers. The bill also includes a provision allowing retailers to claim the credit directly when selling qualifying bicycles, reducing the upfront cost for consumers.

Maddy summaryHR 1610 would modernize Medicare coverage for chiropractic care by removing the current restriction that limited beneficiaries to one chiropractic service per visit. It expands coverage to include all services provided by licensed chiropractors within their state-authorized scope, aligning Medicare with VA, military, and private insurance practices. The bill requires chiropractors to complete a Secretary-approved educational webinar to cover non-spinal services, while still allowing payment for spinal manipulation treatments without this requirement. This directly affects Medicare beneficiaries seeking chiropractic care and chiropractors seeking Medicare reimbursement for their services.

Maddy summaryThe Affordable Insulin Now Act (HR 1488) requires health insurance plans and issuers to cover specific insulin products with cost-sharing capped at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, starting in 2024. It directly affects people with diabetes who rely on insulin by limiting out-of-pocket costs for covered products. The bill mandates coverage of all insulin types (rapid-acting, long-acting, etc.) and dosage forms (vials, pumps, etc.) as selected by the plan. This applies to both group and individual health insurance plans under the Public Health Service Act, Internal Revenue Code, and ERISA, with cost-sharing counting toward annual deductibles.