Rep. Adrian Smith

Maddy summaryHR 1795, the Homecare for Seniors Act, allows seniors to use funds from their Health Savings Accounts (HSAs) to cover qualified home care services. It amends tax law to define "qualified home care" as contracts providing three or more specific personal assistance services (like help with eating, bathing, toileting, or medication) from a licensed provider. The bill directly affects seniors with HSAs who need in-home care, expanding their tax-free distribution options beyond traditional medical care. It also requires the federal government to run a public awareness campaign about these new eligible home care expenses. The changes apply to expenses paid after the bill's enactment date.

Maddy summaryThis bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.

Maddy summaryHR 1666 extends deadlines for ambulance service reimbursement rules under Medicare. It amends Section 1834(l) of the Social Security Act by changing dates from 2025 to 2028 in two specific provisions: paragraph (12)(A) and paragraph (13)(A). This delay gives ambulance providers additional time to adjust to existing Medicare payment rules. The bill directly affects Medicare-certified ambulance services and the patients relying on ground ambulance care covered by Medicare.

Maddy summaryThe Prevent Interruptions in Physical Therapy Act of 2023 amends Medicare rules to allow physical therapists to use temporary replacement providers (locum tenens) for outpatient physical therapy services, aligning with existing provisions for physicians. This directly affects Medicare beneficiaries receiving physical therapy and physical therapy practices needing temporary staffing solutions during provider shortages. The bill updates the Social Security Act to extend the current physician locum tenens rule to physical therapists, ensuring continuity of care without requiring separate approval for temporary coverage. It applies to services furnished after the bill's enactment date.

Maddy summaryThe HELLPP Act (HR 1634) amends Medicaid to recognize doctors of podiatric medicine (podiatrists) as physicians, enabling them to be reimbursed for services under Medicaid starting January 1, 2024. It also clarifies Medicare’s documentation requirements for therapeutic shoes for people with diabetes, mandating specific written certifications from a managing physician and a podiatrist to confirm medical necessity. These changes directly affect patients with foot conditions, especially those with diabetes, by improving access to podiatrist-provided care and coverage for therapeutic shoes. The bill includes a separate provision strengthening Medicaid program integrity through continuous levies on provider payments, but this does not alter patient coverage. All key provisions take effect on January 1, 2024.

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 Critical Access Hospital Relief Act of 2023 removes a Medicare requirement that hospitals needed a physician's certification within 96 hours for inpatient services. This change directly affects critical access hospitals (CAHs), which are typically small, rural facilities serving remote communities. The bill amends Section 1814(a) of the Social Security Act to delete the 96-hour certification rule, effective January 1, 2024. This reduces administrative burden for CAHs by eliminating a specific documentation step for patient admissions. The policy change streamlines Medicare billing processes without altering payment rates or other core hospital services.

Maddy summaryThe Commonsense Reporting Act of 2023 creates a voluntary reporting system for employers that offers minimum essential health coverage to full-time employees, allowing them to meet their reporting requirements under the Affordable Care Act through a single, streamlined process. Employers would report details about their coverage, including whether it meets minimum value requirements, whether it's offered to dependents, and any waiting periods, to help accurately determine eligibility for premium tax credits and cost-sharing subsidies. The system, available starting January 1, 2024, includes provisions for electronic delivery of statements and extended appeal periods for employers facing shared responsibility payments under Section 4980H of the Internal Revenue Code.

Maddy summaryThis bill changes how Medicare pays for certain outpatient services provided by off-campus hospital departments. It allows these services to be paid under the hospital outpatient payment system (instead of physician fees) if the previous year's total Medicare payments for that physician specialty were under $2 million. It directly affects hospitals with off-campus outpatient departments offering services in specialties with low physician payment volumes. The change applies to services furnished starting in 2024, aiming to stabilize payments for these specific outpatient services.

Maddy summaryHR 589, the MAHSA Act, imposes U.S. sanctions on Iran's Supreme Leader, President, and affiliated entities responsible for human rights abuses and terrorism. It targets the Supreme Leader's Office, the President's cabinet, security forces involved in the crackdown following Mahsa Amini's death, and entities financing abuses. The bill requires the President to annually determine and apply existing sanctions - like property blocking and visa bans - against these individuals and entities. This directly affects Iran's top leadership and security apparatus, aiming to hold them accountable for abuses including the Morality Police's role in Amini's detention and the subsequent violent suppression of protests.