Sen. Susan M. Collins

Maddy summaryThe Safe Step Act requires health insurance plans and employer-sponsored health coverage to create a transparent process for patients or their doctors to request exceptions to medication step therapy protocols. These protocols typically mandate trying a lower-cost drug first before covering a more expensive alternative. Exceptions must be approved if previous treatments failed, delaying coverage would cause severe harm, the required drug is unsafe, or the patient is stable on the requested drug. Health plans must respond to requests within 72 hours (or 24 hours in emergencies) and make the process details available online.

Maddy summaryS 626, the Comprehensive Care for Alzheimer’s Act, establishes a new Medicare model to provide coordinated care management for beneficiaries with Alzheimer’s disease or related dementia. It directly affects Medicare Part A/B enrollees (not in Part C or hospice) and their unpaid caregivers by requiring eligible entities like health systems or ACOs to deliver comprehensive services including continuous monitoring, personalized care plans, medication management, and caregiver support. Key provisions include assigning patients to care pathways based on health needs, requiring zero cost-sharing for beneficiaries, and paying providers via capitated payments with quality-based bonuses. The model aims to test whether this approach improves health outcomes, caregiver experience, and reduces Medicare spending without lowering care quality.

Maddy summaryThis bill increases the federal tax credit for rehabilitating historic buildings, specifically boosting the credit rate from 20% to 30% for small projects (defined as those with qualified rehabilitation costs under $3.75 million and no prior credit). The total credit for any single project is capped at $750,000. It also expands eligibility by changing how building basis is calculated and adjusts rules for tax-exempt properties to simplify compliance. These changes directly benefit small-scale developers and owners rehabilitating certified historic structures.

Maddy summaryThis bill repeals two provisions that reduce Social Security benefits for certain public-sector retirees. It eliminates the government pension offset (GPO), which currently cuts Social Security checks for people with government pensions, and removes the windfall elimination provision (WEP), which reduces benefits for those with pensions from jobs not covered by Social Security. The changes directly affect public employees (like teachers, firefighters, and state/local government workers) who have pensions from jobs that didn't pay into Social Security. The bill takes effect for Social Security benefits paid after December 2023, restoring full benefits for eligible retirees.

Maddy summaryThis bill changes how often federal credit unions must hold board meetings based on their performance ratings. For all federal credit unions, boards must meet at least monthly for the first 5 years after their charter is approved. After that, credit unions rated 1 or 2 (highest performance) must meet at least 6 times yearly (with one per quarter), while those rated 3-5 must meet monthly. The bill directly affects all federal credit unions by adjusting their board meeting requirements according to their Uniform Financial Institutions Rating System score. These changes aim to align meeting frequency with credit union performance and oversight needs.

Maddy summaryThis bill directs the Federal Trade Commission (FTC) to study and report on practices in the pharmaceutical supply chain, focusing on pharmacy benefit managers (PBMs) and their impact on drug pricing. The FTC must submit an interim report within 180 days and a full report within one year, examining issues like whether PBMs steer patients to pharmacies they own, use proprietary data for competitive advantage, or design formularies to favor higher-cost drugs. The reports will also assess competition in the supply chain, legal barriers to enforcement, and the FTC’s ability to address anticompetitive behavior by drug manufacturers. The goal is to identify transparency gaps and recommend policy changes to improve competition and ensure consumers benefit from cost savings.

Maddy summaryThis resolution designates February 6-10, 2023, as "National School Counseling Week" in the U.S. Senate. It symbolically recognizes the role of school counselors in supporting students' academic, social, and emotional development. The resolution encourages public awareness of counselors' contributions to student success and school safety but does not create new policies, funding, or requirements. It directly affects school counselors and communities by highlighting their work during this designated week.

Maddy summaryThis resolution establishes a procedural requirement for the U.S. Senate to review international pandemic agreements negotiated under the World Health Organization (WHO). It mandates that any WHO agreement on pandemic prevention, preparedness, or response - where the U.S. would make significant commitments - must be submitted to the Senate as a treaty requiring approval before implementation. The resolution requires the President to submit such agreements to the Senate within 60 days of signing, with the Senate declaring it "not in order" to fund or implement any such agreement without prior Senate ratification. This affects how the executive branch handles WHO pandemic agreements, ensuring Senate consultation and approval aligns with constitutional treaty procedures.

Maddy summaryS 566, the "Charitable Act," modifies tax deductions for charitable contributions for individuals who do not itemize their deductions on federal income taxes. It allows these taxpayers to deduct up to one-third of their standard deduction amount for 2023 and 2024 tax years, instead of the usual itemized deduction. The bill also removes references to a repealed penalty provision (Section 6662(b)(10)) and adjusts related penalty language in the tax code. This directly affects non-itemizing taxpayers who make charitable contributions, providing a new deduction option for those years only. The changes apply to tax years beginning after December 31, 2022.

Maddy summaryThe DAIRY PRIDE Act (S 549) amends federal food labeling rules to prevent plant-based products from using dairy-related terms like "milk," "yogurt," or "cheese" unless they meet the FDA's definition of dairy: derived from the lacteal secretion of hooved mammals (e.g., cows). It directly affects manufacturers of plant-based alternatives (e.g., almond, oat, or coconut milk) that currently label products with dairy terms. The bill requires the FDA to enforce this definition through new guidance within 180 days of enactment, clarifying that products not meeting the standard cannot be marketed as dairy. It does not change nutritional requirements but aims to reduce consumer confusion about product composition.