Rep. Gregory F. Murphy

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 summary# Summary of Tariff Suspensions and Reductions Document This document is a section of U.S. tariff legislation that adds new duty suspensions and reductions to the Harmonized Tariff Schedule of the United States. It contains 120 new tariff items (numbered 9902.19.01 through 9902.20.24) that provide temporary duty-free or reduced-duty status for various goods. Key features of the document: 1. **Content**: The list includes chemical compounds, food ingredients, and specialty materials (such as shelled pine nuts, licorice extract, refined carrageenan, various chemicals like neodymium metal, tungsten concentrate, and numerous organic compounds). 2. **Tariff Treatment**: Most entries are listed as "Free" (meaning duty-free), with a few having small duty rates (e.g., 0.7%, 1.8%, 2.3%, 2.9%, 4.3%). 3. **Effective Period**: All listed suspensions and reductions are effective "On or before 12/31/2025." 4. **Purpose**: These tariff suspensions are intended to support specific industries, reduce costs for manufacturers, or provide temporary relief for certain imported goods. 5. **Technical Details**: Each entry includes the chemical name, CAS number, Harmonized Tariff Schedule code, duty rate, and a brief description of the product. This document represents a legislative amendment to the Harmonized Tariff Schedule, specifically adding new subchapter II of chapter 99 to provide temporary duty relief for these specific items.

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 permanently extends Medicare reimbursement for telehealth services provided by federally qualified health centers (FQHCs) and rural health clinics (RHCs). It removes the previous time limit that tied telehealth coverage to a declared public health emergency or a 151-day post-emergency period. The key change modifies the Social Security Act to allow these clinics to continue offering telehealth services under Medicare without time restrictions. This directly affects FQHCs and RHCs, primarily serving rural and underserved communities, by ensuring ongoing access to Medicare payments for virtual care. The policy change makes telehealth coverage for these providers permanent, not temporary.

Maddy summaryThis bill requires Medicare Advantage (MA) plans to maintain accurate, publicly accessible provider directories containing essential details like provider names, specialties, contact information, and accessibility features. MA organizations must verify directory accuracy quarterly (or annually for hospitals), remove outdated providers within 5 business days, and clearly flag outdated information. If a beneficiary relies on an incorrect directory listing for a non-participating provider, the MA plan must cover the same cost-sharing as if the provider were in-network. These requirements apply to all network-based MA plans starting in 2026, with annual accuracy reports and public score disclosures beginning in 2027.

Maddy summaryThis bill changes the negotiation period for small-molecule drugs under the federal Drug Price Negotiation Program from 7 years to 11 years, matching the existing 11-year period for biologic drugs. It directly affects drug manufacturers participating in the program by extending the timeframe for price negotiations with the government. The amendment applies to all small-molecule drugs covered under the program, creating a uniform negotiation timeline for both drug types. The change takes effect as if included in the Inflation Reduction Act of 2022.

Maddy summaryThe Preserving Seniors’ Access to Physicians Act of 2023 increases the Medicare payment adjustment rate for physicians from 1.25% to 4.62%, directly affecting doctors who treat Medicare patients (primarily seniors). It also reduces the funding for the Medicaid improvement fund from $5,796,117,810 to $3,973,117,810. These changes impact Medicare providers and Medicaid programs, with the Medicare adjustment aimed at supporting physicians adjusting to payment changes. The bill does not specify how the Medicaid funding reduction relates to its stated goal of preserving seniors' access to physicians.

Maddy summaryThis bill updates Medicare's physician fee schedule to better align with current healthcare costs and support providers. It extends a key deadline for geographic payment adjustments from 2024 to 2025, increases the rate for payment adjustments from 1.25% to 3%, and extends incentive payments for doctors in alternative payment models (APMs) through 2026. For 2026, it imposes payment reductions (34% for 4-6 years in APMs, 67% for 7+ years) but allows exceptions if providers increased their financial risk compared to 2025. The bill also raises Medicare's budget neutrality threshold to $53 million in 2025 and requires regular updates to cost data (like staff wages and equipment prices) every five years. These changes directly affect Medicare-participating physicians, especially those in APMs, by altering payment calculations and incentives.

Maddy summaryThis bill prohibits health insurance plans from charging healthcare providers fees for electronic payments (EFTs) and payment advice transactions. It directly affects doctors, hospitals, and clinics that receive electronic payments from health plans by banning any charges, including withholdings, for these transactions. The law, effective January 1, 2024, amends the Social Security Act to require health plans to cover these costs themselves, eliminating fees for providers.

Maddy summaryHR 6465, the PLASMA Act, amends Medicare Part D's discount program to create a specific phase-in for plasma-derived specialty drugs. It directly affects Medicare Part D beneficiaries who use these drugs and reach their annual out-of-pocket spending limit. The bill establishes a new "specified plasma-derived product percent" to calculate discounted prices for these drugs, based on whether beneficiaries have already met their out-of-pocket threshold for other Part D drugs. This changes how manufacturers' negotiated prices are discounted for plasma-derived products under the existing program, without creating new benefits or altering coverage.