Maddy summaryThis bill updates Medicare physician payment rules to improve stability and accuracy. It raises the budget neutrality threshold from $20 million (pre-2025) to $53 million in 2025, with annual indexing after 2026, to prevent excessive payment adjustments. The bill requires the Medicare program to correct budget neutrality payments based on actual service utilization data (not estimates) starting in 2025, and mandates updating direct cost inputs (like staff wages and equipment prices) every 5 years. It also caps annual changes to the physician payment conversion factor at 2.5% to limit sudden payment shifts, directly affecting Medicare physicians and healthcare providers receiving these payments.
Rep. Gregory F. Murphy
Sponsored bills
Maddy summaryThe PILLS Act creates tax credits to encourage domestic production of generic drugs and biosimilars. It provides a production credit (up to 35% of value added for final drug production) for manufacturers producing eligible drugs in the U.S., with additional bonus credits for domestically sourced materials. The bill also establishes a 25% investment credit for qualified facilities building new production capacity, with both credits phasing out after 2029 and terminating for new construction after 2027. These provisions directly affect U.S. pharmaceutical manufacturers of generic drugs and biosimilars, aiming to increase domestic supply of these medications.
Maddy summaryThis bill, HR 5796, prohibits the Department of Health and Human Services from implementing a proposed rule requiring minimum staffing levels in nursing homes. It creates an advisory panel of 15 members - including rural nursing home staff and experts - to study workforce shortages and report on access barriers for seniors, especially in rural areas. The panel must submit an initial report within 60 days, analyzing staffing challenges and recommending solutions to strengthen the nursing home workforce. These provisions directly aim to prevent nursing home closures (like the 129 that occurred in 2022) that threaten rural seniors’ access to care.
Maddy summaryHR 5614 extends duty-free treatment for Haitian apparel imports under the Caribbean Basin Economic Recovery Act until September 30, 2035. It modifies the quantitative limit for eligible apparel imports to cap at 1.25% of the U.S. market for the most recent 12-month period, replacing the previous fixed annual period structure. This bill directly affects Haitian apparel exporters and U.S. importers of Haitian-made clothing by maintaining tariff preferences. The extension also requires the President to adjust the Harmonized Tariff Schedule to restore lost benefits for eligible items affected by prior tariff schedule changes.
Maddy summaryThe DRA of 2023 adjusts Medicare payment rates for specific durable medical equipment (DME) items that were part of the 2021 competitive bidding program but for which no supplier contracts were finalized. It directly affects DME suppliers and Medicare beneficiaries by establishing a new 2024 payment formula: 90% of the adjusted payment amount plus 10% of the unadjusted fee schedule for eligible items. The bill also extends a temporary transition rule for non-rural areas through December 31, 2024, while delaying a regulatory change until 2025. These provisions aim to stabilize payments for DME items that did not transition to standard pricing under prior rules.
Maddy summaryHR 5391 requires drug manufacturers to pay rebates to Medicare when the price of certain high-cost cancer drugs (called "selected drugs") exceeds a negotiated "maximum fair price" (MFP). This applies to Medicare Part B beneficiaries using these specific drugs, lowering their out-of-pocket costs. The bill mandates manufacturers to calculate rebates based on the difference between current Medicare payment rates (ASP+6) and the new MFP-based rates, reducing beneficiary coinsurance from ASP+6 to MFP+6. The rebates are deposited into Medicare's trust fund and apply to drugs already subject to MFP negotiations under existing law.
Maddy summaryThis bill changes Medicare billing rules to make remote patient monitoring more accessible. It requires Medicare to cover remote monitoring services with a minimum of 2 days of patient data collected over a 30-day period (instead of the current 16 days), affecting Medicare beneficiaries and healthcare providers. The policy applies to all patients, not just those with COVID-19, and is effective for two years after enactment. The bill also mandates a report to Congress within one year analyzing remote monitoring data and recommending future reimbursement models based on patient needs.
Maddy summaryHR 5193, the Senior Citizens’ Freedom to Work Act of 2023, repeals the Social Security Retirement Earnings Test. This means seniors receiving Social Security benefits who continue working will no longer have their benefits reduced based on their earnings. The bill removes specific provisions in the Social Security Act that previously deducted benefits for individuals under full retirement age who earned above a set limit. The change applies to taxable years ending after December 31, 2023, directly affecting working seniors who previously faced benefit reductions.
Maddy summaryThis bill requires Medicare Advantage (MA) plans and prescription drug plans (PDPs) to disclose ownership ties to healthcare providers and pharmacies starting in 2025, reporting details like taxpayer IDs and financial transactions. MA plans must share data on payments to providers they control, while PDP sponsors must disclose pharmacy ownership links. The Medicare Payment Advisory Commission (MedPAC) will analyze these relationships every three years, assessing how ownership ties affect healthcare costs, access, and quality. The goal is to increase transparency around how Medicare plan ownership structures may influence care delivery and pricing.
Maddy summaryHR 3674 increases Medicare payments for specific physician services that rely heavily on equipment and supplies (defined as services where 65%+ of costs are for equipment/supplies). It raises payment rates by 10% in 2024 and 15% in 2025 for these services in non-hospital settings like doctor's offices. The bill funds these increases through federal appropriations to the Medicare Trust Fund. It directly affects physicians and clinics providing those defined services, aiming to stabilize reimbursement for providers of high-cost equipment-dependent care.