Rep. Adrian Smith

Maddy summaryThe Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.

Maddy summaryThis bill modifies tax rules for vaccines by adding new vaccines to the list of taxable vaccines under federal law. Specifically, it includes any vaccine placed on the Vaccine Injury Table under the Public Health Service Act, which determines eligibility for compensation for vaccine-related injuries. Manufacturers and distributors will need to account for these vaccines under the tax code once HHS adds them to the injury compensation list. The change affects tax reporting for these specific vaccines but does not alter vaccine access, costs, or the injury compensation program itself.

Maddy summaryThis bill expands Medicare coverage to include home infusion treatment for people with Alpha-1 Antitrypsin Deficiency Disorder, a genetic condition causing lung and liver damage. It specifically covers "augmentation therapy" (a standard treatment using Alpha-1 Proteinase Inhibitor) when administered in a patient's home by qualified providers. Medicare will pay 80% of the cost for intravenous kits and up to 2 hours of nursing care during these home infusions, starting January 1, 2025. The change directly affects Medicare beneficiaries with this condition who require home-based treatment and their qualified home infusion providers.

Maddy summaryThis bill prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.

Maddy summaryThis bill amends Medicare rules to improve access to home infusion therapy, which delivers IV medications at home for conditions like chronic diseases. It adds pharmacy services (including drug preparation and compounding) to covered Medicare benefits and creates a payment rule: if a supplier isn't physically present during therapy, Medicare pays 50% of the full rate instead of denying payment. It also allows nurse practitioners and physician assistants to establish and review home infusion care plans, previously limited to physicians. These changes, effective January 2024, directly affect Medicare beneficiaries requiring home infusion therapy and providers delivering these services.

Maddy summaryThis bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.

Maddy summaryThe Formula 3.0 Act removes tariffs on infant formula base powder (a dry mixture requiring only vitamins/minerals to become formula) for manufacturers authorized by the FDA to market infant formula in the U.S. It creates a new duty-free tariff classification (1901.90.57) for this base powder, effective 120 days after enactment. This directly affects infant formula manufacturers and importers who meet FDA authorization requirements. The bill modifies U.S. tariff schedules to eliminate duties on specific infant formula components, aiming to reduce import costs for compliant manufacturers.

Maddy summaryHR 3739, the FAIR TARIFF Act of 2023, requires U.S. Customs to refund overpaid duties for specific imports from European Union countries during two defined periods: October 18-December 17, 2019, and January 12-February 10, 2022. It targets products classified under certain Harmonized Tariff Schedule codes (e.g., 9903.89.10-9903.89.49 for 2019, 9903.89.57-9903.89.59 for 2022) that were incorrectly taxed due to tariff misclassification. Importers must apply for refunds within one year of the law’s enactment, with refunds processed within 180 days of application. The bill also mandates a 60-day advance notice in the Federal Register before implementing new tariff increases under Section 301 of the Trade Act of 1974.

Maddy summaryThis bill simplifies regulations for rural health clinics (RHCs) by reducing administrative burdens. It allows RHCs to contract with physician assistants and nurse practitioners (instead of requiring direct employment), updates the definition of "rural" to exclude areas with 50,000+ residents, and removes outdated lab service requirements by requiring only "prompt access" to clinical labs. These changes directly affect RHCs, enabling them to more flexibly staff and operate while complying with state practice laws. The amendments take effect January 1, 2024, applying to services provided on or after that date.

Maddy summaryThis bill grants the President new authority to negotiate a comprehensive trade agreement with the United Kingdom to reduce tariffs and other trade barriers. It requires negotiations to begin within 180 days of enactment and sets a March 1, 2025 deadline for finalizing an agreement. The bill includes specific limits on tariff reductions, preventing cuts below 50% of current rates for most goods or below Uruguay Round levels for agricultural products. This would directly affect U.S. businesses, farmers, and consumers by potentially lowering import costs and expanding market access for U.S. exports.