Rep. Diana Harshbarger

Maddy summaryThe Pharmacy Benefit Manager Sunshine and Accountability Act requires Pharmacy Benefit Managers (PBMs) to publicly disclose detailed financial information about their contracts with drug manufacturers and health plans. Specifically, PBMs must report total rebates received, administrative fees collected, amounts retained (not passed through to health plans), and the retained rebate percentage for each contract. This data, including the highest and lowest retained rebate percentages across all contracts, must be submitted annually to the Department of Health and Human Services and published on a public website. The bill directly affects PBMs and the health plans/insurance issuers they serve by increasing transparency in how drug pricing and rebates are managed.

Maddy summaryHR 2707, the MADE in America Act, creates a 25-30% federal tax credit for manufacturers producing specific health products (including drugs, medical devices, personal protective equipment, and diagnostic tools) in designated "distressed zones." These zones are census tracts with over 30% poverty rates that are also designated as qualified opportunity zones. The credit applies to wages paid to employees working in these zones and qualified production costs (like equipment and materials), increasing to 30% if most employees reside locally. It directly affects pharmaceutical and medical device manufacturers operating in eligible low-income areas, aiming to incentivize domestic production of critical health products.

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 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 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 summaryThis bill makes permanent Medicare coverage for cardiac and pulmonary rehabilitation services delivered via telehealth in patients' homes, which were temporarily allowed during the pandemic. It removes geographic restrictions that previously required in-person visits or limited services to specific locations like clinics. The change directly affects Medicare beneficiaries needing heart or lung rehabilitation and healthcare providers offering these programs. It ensures home-based telehealth visits for cardiac, intensive cardiac, and pulmonary rehabilitation receive the same coverage as in-clinic services under Medicare.

Maddy summaryHR 1276, the "Protect Minors from Medical Malpractice Act of 2023," creates a legal right for minors who undergo gender-transition procedures before age 18 to sue medical practitioners for harms (physical, psychological, or emotional) related to those procedures. It allows such individuals to file civil lawsuits up to 30 years after turning 18, seeking damages, injunctions, or attorney fees. The bill defines "gender-transition procedure" broadly to include puberty blockers, cross-sex hormones, or surgeries, but excludes treatments for intersex conditions, medical emergencies, or injuries caused by prior procedures. This law directly affects minors receiving such care, medical practitioners performing these procedures, and states that might require them. The bill does not prohibit gender-transition care but establishes a liability framework for practitioners.

Maddy summaryThe Rural Physician Workforce Production Act of 2023 creates a new payment system to support medical residency training in rural areas. It allows hospitals, critical access hospitals, and rural emergency hospitals to receive additional payments for residents who train at least 8 weeks in rural locations, with payments based on national medical training costs adjusted annually. The bill requires hospitals to pay residents' salaries during rural training and defines "rural training location" using census data (rural areas, rural-urban commuting area codes, or locations near sole community hospitals). This program is designed to increase rural physician training without affecting existing residency program limits or Medicare funding for medical education. Payments are budget-neutral, meaning they won't increase overall Medicare spending on medical education.

Maddy summaryHR 751, the FAIR Act, requires hospitals running medical residency programs to report annual data on applicants and acceptances from both osteopathic (DO) and allopathic (MD) medical schools starting in 2024. Specifically, hospitals must submit the number of applicants and accepted candidates from each medical school type, confirm they accept both DO and MD applicants, and state that COMLEX and USMLE exam scores are equally accepted. The Health Secretary must then publish this data online for public transparency. The bill directly affects hospitals operating residency programs and aims to make their admissions processes more visible, without mandating specific acceptance rates or changing admission criteria.

Maddy summaryThis bill amends the Social Security Act to exclude wages earned and self-employment income derived from unauthorized employment in the United States from being counted toward Social Security credits. It directly affects undocumented immigrants who work without authorization, preventing those earnings from contributing to their future Social Security benefits. The law changes existing Social Security rules by adding specific exclusions for "service performed by an alien while employed... not authorized to be so employed" and similar self-employment activities. These changes apply to all wages and income earned before, during, or after the bill's enactment, with Social Security recompiling existing benefit calculations to reflect the new rules.