Rep. Kevin Hern

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 3095, the "Address Iran’s Malign Posture Act," expands U.S. sanctions to target foreign entities providing financial services, material support, or acting on behalf of Iran’s Revolutionary Guard Corps or designated terrorist groups. It requires the President to block all U.S. financial transactions with these entities and mandates that any nuclear agreement with Iran must be approved by a two-thirds vote in the Senate as a treaty. The bill also sets a 2025 sunset date for these sanctions provisions and related waivers. This directly affects foreign banks, businesses, and individuals engaging in transactions with Iran’s military or terror-linked entities.

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.

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 summaryThe Emergency Care Improvement Act would permanently allow freestanding emergency centers (FECs) to receive Medicare and Medicaid reimbursement for emergency services. FECs are independently licensed facilities operating 24/7 with on-site physicians, providing emergency care equivalent to hospital-based emergency rooms. The bill sets payment rates for FECs equal to hospital outpatient department rates for higher-level emergency services, based on existing Medicare payment structures. This change would apply to over 110 FECs, mostly in Texas, which previously operated under a temporary pandemic waiver and demonstrated 21.8% cost savings to Medicare for similar care.

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 summaryThis bill requires Medicare and Medicaid to cover prescription digital therapeutics - software-based treatments for medical conditions like diabetes or mental health disorders - starting January 1, 2024. It mandates Medicare to establish payment rates for manufacturers within one year and create specific billing codes within two years, with temporary codes used until permanent codes are set. Manufacturers must report annual data on pricing, usage, and discounts to Medicare, facing penalties of up to $10,000 per day for incomplete or false reports. The bill directly affects Medicare/Medicaid beneficiaries, digital therapeutic companies, and the healthcare billing system by integrating these treatments into federal coverage.

Maddy summaryHR 1399, the "Protect Children's Innocence Act," prohibits medical gender-affirming care for minors under 18 by making it a class C felony for providers to perform such care. The bill defines gender-affirming care broadly to include surgical procedures, hormone treatments, and certain cosmetic procedures, with exceptions for medical conditions like reproductive cancers or intersex conditions. It prohibits federal funding for gender-affirming care through programs like Medicaid, Medicare, and the Affordable Care Act, and bans such care in federal health facilities. The bill also prevents institutions of higher education from teaching gender-affirming care and adds immigration consequences for individuals who provide such care to minors.

Maddy summaryHR 1170, the Access to Future Cures Act, would allow individuals to deduct the cost of storing their blood or related biomaterials (like stem cells) as a medical expense on federal income taxes. This directly affects patients who pay for such storage to potentially use in future medical treatments, such as stem cell therapies. The bill amends the tax code to explicitly include these storage costs under qualified medical expenses, which were previously excluded. The change would take effect after the bill is signed into law.

Maddy summaryThis bill repeals specific provisions from the Affordable Care Act and its 2010 amendment that restricted certain physician referrals to hospitals under Medicare. It directly affects hospitals and physicians who previously faced limitations on referring Medicare patients to facilities they owned or had financial ties with. The key mechanism restores the original rules that allowed such referrals without the prior restrictions, effectively undoing the 2010 changes. This is a procedural change to existing law, not a new policy.