Rep. Diana Harshbarger

Maddy summaryHR 3674 increases Medicare payments for specific physician services that rely heavily on equipment and supplies (defined as services where 65%+ of costs are for equipment/supplies). It raises payment rates by 10% in 2024 and 15% in 2025 for these services in non-hospital settings like doctor's offices. The bill funds these increases through federal appropriations to the Medicare Trust Fund. It directly affects physicians and clinics providing those defined services, aiming to stabilize reimbursement for providers of high-cost equipment-dependent care.

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of requiring direct employment), updates the definition of "rural" to exclude areas with 50,000+ residents, and removes outdated lab service requirements by requiring only "prompt access" to clinical labs.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 establishes a minimum payment floor for Medicare reimbursements to rural hospitals not located in frontier states. It sets a 0.85 minimum for the area wage index used in hospital inpatient payments (starting October 2023) and a similar floor for outpatient department payments (starting January 2024). This prevents Medicare payments from dropping below 85% of the standard wage index for eligible rural hospitals. The bill includes budget neutrality requirements to ensure overall Medicare payments don't increase, while exempting hospitals already receiving payments above the floor.

Maddy summaryHR 3561, the PATIENT Act of 2023, requires hospitals, health insurance plans, and pharmacy benefit managers to publicly disclose detailed pricing information for healthcare services and drugs. Hospitals must publish standard charges for 300+ shoppable services, including gross charges, payer-specific negotiated rates, and discounted cash prices, with updates required annually. Health plans must provide real-time information on in-network rates, cost sharing, deductibles, and prior authorization requirements for covered services. The bill establishes enforcement mechanisms, including civil monetary penalties for non-compliance, with fines ranging from $300 per day for small hospitals to $5 million for large hospitals that fail to comply with the transparency requirements.

Maddy summaryHR 3285, the Fairness for Patient Medications Act, requires health insurance plans and pharmacy benefit managers to limit patient cost-sharing for "highly rebated drugs" (drugs where manufacturers rebate over 50% of annual spending). Starting January 2025, plans must cap out-of-pocket costs per 30-day supply at 1/12 of the drug’s net price (after rebates), calculated annually. The bill also prohibits hidden discounts from drug manufacturers when plans add previously excluded drugs to coverage, requiring price reductions to be visible at checkout or limited to flat service fees. This directly affects health insurance plans, insurers, and pharmacy benefit managers managing prescription drug coverage.

Maddy summaryHR 3282 requires Medicare Advantage plans and Part D prescription drug plans to disclose detailed financial and operational data about ownership relationships with providers and pharmacies. Starting in 2025, these plans must report information such as payment patterns, risk scores, rebate structures, and medical loss ratios for services provided by entities they own or control. The data, collected annually, will be made publicly available by 2027 in aggregated, non-identifying form to promote transparency. This affects Medicare Advantage organizations, Part D sponsors, and pharmacy benefit managers participating in Medicare.

Maddy summaryThis bill prohibits federal funding for gender transition procedures - including hormone therapy, puberty blockers, and surgeries like genital reassignment - across all federal programs and health plans. It exempts procedures for medical conditions (such as disorders of sex development) and treatment of complications arising from such procedures. The bill also blocks Affordable Care Act premium tax credits and cost-sharing reductions for health plans covering these services, though individuals may purchase separate non-federal-funded coverage. State and private insurers can still offer such coverage using their own funds, but federal subsidies cannot be applied to it.

Maddy summaryHR 3227, the Ensuring Seniors’ Access to Quality Care Act, amends Medicare and Medicaid rules to address nurse aide training programs in nursing facilities. It allows the Secretary of Health and Human Services to disapprove a facility’s nurse aide training program for up to two years if the facility received a $10,697+ civil penalty for substandard care and hasn’t corrected the quality issues. Facilities can have disapproval lifted by proving they fixed the care deficiencies, haven’t had recent patient harm incidents, and the penalty didn’t involve immediate patient jeopardy. The changes apply only to penalties assessed after the bill’s enactment and do not affect facilities already prohibited under prior rules.

Maddy summaryThis bill repeals the tax on Social Security benefits for seniors, making those benefits fully tax-free. It directly affects seniors who receive Social Security benefits and are currently subject to income tax on a portion of those payments. The key provision removes Section 86 of the tax code that previously included benefits in gross income, while a separate funding mechanism appropriates money to Social Security trust funds to replace the lost revenue. The bill ensures Social Security trust funds remain fully funded without requiring new tax increases.

Maddy summaryThis bill regulates pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans. It prohibits PBMs from earning income based on drug prices or rebates (requiring flat fees instead), mandates equal reimbursement for all network pharmacies, and requires PBMs to report how much of drug rebates they pass through to Medicare plans. The law also mandates annual compliance certifications and requires the government to publish aggregated transparency data (without revealing specific plan details) starting in 2024. These changes directly affect Medicare Part D plans and the seniors who rely on them for prescription drug coverage.