Rep. Tom Cole

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.

Maddy summaryThis bill, HR 6860, protects patients with end-stage kidney disease (ESRD) who require dialysis by preventing health insurance plans from discriminating against them. It amends Medicare rules to prohibit plans from treating dialysis coverage differently than other medical services based on a patient’s ESRD diagnosis, need for dialysis, or any other factor. The bill clarifies that plans can still choose which dialysis providers to include in their networks but cannot deny or limit coverage for dialysis services solely because of the patient’s condition. It ensures Medicare remains the secondary payer for these services as intended, without forcing plans to cover specific providers.

Maddy summaryThis bill imposes U.S. sanctions on foreign individuals and entities that facilitate North Korea's transfer of arms or material support to Russia for use in Russia's invasion of Ukraine. It targets those responsible for such transfers, including foreign financial institutions enabling significant transactions related to these activities, requiring property blocks and visa restrictions. The bill also amends existing North Korea sanctions to explicitly require halting such material support and mandates the President to submit regular reports to Congress on North Korea's involvement and U.S. strategies to counter it.

Maddy summaryThe Strengthening Tribal Families Act of 2023 requires U.S. states receiving federal child welfare funding to explicitly comply with the Indian Child Welfare Act (ICWA) of 1978. It amends federal law to mandate that state child welfare agencies follow ICWA standards in cases involving Native American children, including timely tribal notice and proper placement decisions. The bill establishes specific metrics for measuring compliance, such as tracking how often courts return cases for insufficient "active efforts" and documenting foster care or adoption placements. States must submit biennial reports to Congress on their progress, and a new federal process will develop standardized compliance assessment tools by 2024. This directly affects state child welfare agencies, tribal organizations, and Native American families involved in custody proceedings.

Maddy summaryThe Strengthening Tribal Families Act of 2023 requires state child welfare agencies to comply with the Indian Child Welfare Act of 1978 (ICWA) in all cases involving Native American children. It amends federal child welfare laws to mandate specific ICWA compliance measures in state plans, such as timely tribal notice in custody cases and proper foster care placements. The bill establishes a system for measuring state compliance, tracking factors like identification of Indian children and court decisions on parental rights. States must submit biennial reports to Congress on their progress in meeting these requirements.

Maddy summaryHR 3387, the No Surprise Bills for New Moms Act, requires health insurance plans and employers to automatically cover newborns for 30 days after birth for any services the plan normally covers, without requiring prior enrollment. This directly affects new parents (including fathers) and their newborns, preventing unexpected bills during the initial post-birth period. The bill also mandates a 60-day special enrollment period to formally add the baby to the plan and requires insurers to notify parents immediately if a claim is filed for an unenrolled newborn. These provisions apply to both employer-sponsored and private health insurance plans.

Maddy summaryThis bill establishes a new workplace violence prevention standard for healthcare and social service workers. It requires employers in covered facilities - including hospitals, nursing homes, mental health clinics, and social service settings - to develop and implement comprehensive prevention plans with specific requirements. These plans must include risk assessments, hazard prevention measures, employee training on violence prevention, and procedures for reporting and investigating violent incidents. The bill also amends Medicare regulations to require compliance with these standards for hospitals and skilled nursing facilities receiving Medicare funds.

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 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 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.