Rep. Adrian Smith

Maddy summaryHR 3417, the FAIR Act, requires hospitals with off-campus outpatient departments (OCODs) to use separate unique health identifiers for those departments by January 1, 2025. It mandates that these departments bill Medicare and other insurers using specific formats (HIPAA X12 837P or CMS 1500) with their unique identifier, rather than billing under individual practitioners. This directly affects hospitals operating OCODs, changing how they submit claims for services provided at those locations. The bill takes effect for claims submitted on or after January 1, 2025, ensuring clearer billing accountability for these departments.

Maddy summaryHR 3423, the SAVE Act, defines "common name" for agricultural products (like "Cheddar" for cheese or "Merlot" for wine) as a term routinely used on packaging, consistent with international standards. It requires the Agriculture Secretary and U.S. Trade Representative to negotiate agreements with foreign countries to protect U.S. producers' right to use these common names in international markets. The bill directly affects U.S. agricultural exporters, processors, and producers who rely on familiar product names. It mandates biennial reports to Congress on these trade efforts, focusing on preserving market access for U.S. goods using common names.

Maddy summaryThis bill requires Medicare to cover specialized monitoring devices that detect dangerous needle dislodgement during home hemodialysis treatments. It directly affects new and respite dialysis patients initiating home care after the law takes effect (one year post-enactment). The key provision establishes a new Medicare payment system for these safety devices, requiring the Secretary to set rates based on device costs, existing Medicare payments, and input from manufacturers and patients. The devices use fiber optics to detect blood leaks and trigger alarms, preventing serious blood loss incidents during treatment.

Maddy summaryThis bill amends Medicare coverage under the Social Security Act to specifically include "items and services needed for the administration of intravenous immune globulin for the treatment of primary immune deficiency disease" in skilled nursing facilities. It directly affects Medicare beneficiaries with primary immunodeficiency diseases who require IV immune globulin treatments in post-acute care settings. The key change adds this specific treatment to Medicare's covered services, ensuring reimbursement for these necessary care components. The amendment takes effect for services provided on or after January 1, 2024.

Maddy summaryThis bill changes tax rules to treat direct primary care (DPC) membership fees as deductible medical expenses. It defines DPC as a fixed monthly fee (capped at $150 per person, $300 for families) for primary care services only, excluding procedures requiring anesthesia, prescription drugs (except vaccines), or lab tests. The law ensures these fees can be claimed on tax returns like other medical costs, while clarifying DPC arrangements aren’t considered health insurance plans. It applies to fees paid for DPC services provided through employment or directly to patients, effective for 2024 tax years.

Maddy summaryThe PASTEUR Act establishes a new subscription payment model to incentivize development of new antimicrobial drugs for resistant infections. It creates a Committee on Critical Need Antimicrobials and a Subscription Contract Office to manage payments based on specific drug characteristics like treating multi-drug resistant infections, novel mechanisms of action, and oral administration. Under this model, the government would pay drug developers up to $3 billion over 10 years for qualifying drugs, with payments tied to requirements like ensuring drug availability, reporting resistance data, and developing appropriate use plans. The bill aims to address the lack of new antimicrobial drugs by changing the funding model to reward drugs that meet specific clinical and public health needs.

Maddy summaryThe Expanding Care in the Home Act establishes new payment models for Medicare home-based care services. It would allow primary care providers to receive monthly capitated payments instead of fee-for-service, expand coverage for home infusion therapy and staff-assisted home dialysis, and create new reimbursement for in-home lab tests and advanced diagnostic imaging. The bill also establishes coverage for personal care services (up to 12 hours weekly) and funds workforce development programs for home-based care providers. These changes would directly affect Medicare beneficiaries needing home care and the healthcare providers who deliver those services. The legislation aims to improve access to coordinated care in home settings through new payment structures and expanded service coverage.

Maddy summaryThe I CAN Act (Improving Care and Access to Nurses Act) expands healthcare access by removing barriers for nurse practitioners, clinical nurse specialists, physician assistants, certified registered nurse anesthetists, and certified nurse-midwives within Medicare and Medicaid programs. Key provisions include allowing these professionals to provide cardiac and pulmonary rehabilitation services, prescribe certain diabetic shoes, and deliver hospice care without unnecessary physician supervision. The bill also clarifies reimbursement for services provided by certified nurse anesthetists and improves access to home health services through certified nurse-midwives. These changes directly affect Medicare and Medicaid beneficiaries by potentially increasing access to care and healthcare providers by expanding their scope of practice. The bill aims to improve healthcare delivery by leveraging the skills of advanced practice nurses across multiple care settings.

Maddy summaryThis bill expands Medicare coverage for cardiac and pulmonary rehabilitation programs by updating who can prescribe these services. It allows physician assistants, nurse practitioners, and clinical nurse specialists (in addition to physicians) to authorize these programs under Medicare, broadening access for patients. The changes apply to services starting January 1, 2024, and directly affect Medicare beneficiaries needing cardiac or lung rehabilitation care. The policy simplifies provider eligibility without creating new funding or altering program structure.

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.