Rep. Dan Crenshaw

Maddy summaryHR 5208, the Health Care Provider Shortage Minimization Act of 2023, clarifies tax treatment for temporary healthcare workers. It amends the tax code to specify that locum tenens physicians and advanced care practitioners (like nurse practitioners or physician assistants) providing services for up to one year at a single site are not treated as employees for tax purposes. This means the workers themselves, the healthcare facilities hiring them, and payors avoid employer tax obligations related to these temporary services. The bill directly affects temporary healthcare providers and facilities seeking to fill staffing gaps without complex employment tax compliance.

Maddy summaryThis bill amends Medicare rules to improve access to home infusion therapy, which delivers IV medications at home for conditions like chronic diseases. It adds pharmacy services (including drug preparation and compounding) to covered Medicare benefits and creates a payment rule: if a supplier isn't physically present during therapy, Medicare pays 50% of the full rate instead of denying payment. It also allows nurse practitioners and physician assistants to establish and review home infusion care plans, previously limited to physicians. These changes, effective January 2024, directly affect Medicare beneficiaries requiring home infusion therapy and providers delivering these services.

Maddy summaryHR 3611, the Kazakhstan Permanent Normal Trade Relations Act of 2023, makes Kazakhstan's existing "normal trade relations" (NTR) status permanent by removing the need for annual U.S. presidential reviews under the Trade Act of 1974. This bill directly affects U.S. trade policy with Kazakhstan, ending the requirement for the President to annually determine whether Kazakhstan meets emigration freedom standards (which it has satisfied since 1997). The key provision allows the President to formally extend permanent NTR treatment to Kazakhstan's products, eliminating the current annual review process. Once enacted, Kazakhstan would automatically receive the same most-favored-nation tariff rates as other NTR countries, streamlining trade without further congressional action.

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 summaryThis bill changes tax rules to treat direct primary care (DPC) membership fees as deductible medical expenses. It defines DPC as a fixed monthly fee (capped at $150 per person, $300 for families) for primary care services only, excluding procedures requiring anesthesia, prescription drugs (except vaccines), or lab tests. The law ensures these fees can be claimed on tax returns like other medical costs, while clarifying DPC arrangements aren’t considered health insurance plans. It applies to fees paid for DPC services provided through employment or directly to patients, effective for 2024 tax years.

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 modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

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 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 summaryThis bill targets specific Mexican cartels (Sinaloa, Jalisco New Generation, Beltran-Levya, Gulf, Los Zetas, Tijuana, and La Familia Michoacana/Knights Templar) by increasing penalties for related crimes, prohibiting cartel members from using U.S. financial institutions, and creating a CARTEL Fund to distribute seized assets (75% to Homeland Security, 25% to Justice Department). It establishes new immigration barriers for cartel members and their family members, and imposes penalties on U.S. citizens who facilitate cartel activities. The bill also authorizes sanctions against foreign governments and individuals that support these cartels, including blocking transactions and denying visas. This legislation would directly affect cartel members, their associates, U.S. citizens facilitating cartel activities, and foreign entities supporting these organizations.