HR 4475, the Period PROUD Act of 2023, allocates $1.9 billion over four years (2025-2028) through the Social Services Block Grant Program to provide free menstrual products to low-income menstruating individuals. It requires states to distribute funds to qualified nonprofits for direct product distribution, community outreach, and improving access, while limiting administrative costs to 9% of funds. The bill mandates an evaluation by 2030 to assess health impacts and requires annual reports on program effectiveness. It also establishes best practices for schools on discussing menstruation and exempts funding from automatic budget cuts.
The PrEP Access and Coverage Act of 2023 requires private health insurance plans, Medicare, Medicaid, and other public health programs to cover pre-exposure prophylaxis (PrEP) for HIV prevention without cost-sharing, including the medication, related lab tests, and follow-up care. The bill also prohibits life, disability, and long-term care insurance companies from denying coverage or charging higher premiums to people taking PrEP. It establishes public education campaigns to increase awareness of PrEP and PEP (post-exposure prophylaxis) and creates funding for state and community programs to expand access to HIV prevention services, particularly for populations disproportionately affected by HIV including Black, Hispanic/Latinx, and transgender individuals. The legislation specifically addresses current disparities in PrEP access, as data shows only 11% of Black/African American and 21% of Hispanic/Latinx individuals eligible for PrEP received prescriptions in 2022 compared to 82% of White individuals. Coverage requirements for most plans will take effect on January 1, 2025.
This bill prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.
The Comprehensive Cancer Survivorship Act (HR 4363) establishes new Medicare and Medicaid coverage for cancer care planning and coordination services, requiring personalized survivorship care plans for cancer survivors from diagnosis through the end of life. The bill creates a demonstration program to test different models of survivorship care, including navigation services to help survivors transition from cancer treatment to ongoing care, and mandates Medicaid coverage for cancer fertility services. It also establishes a comprehensive cancer survivorship program with resource centers for survivors and health care providers, and includes provisions to help cancer survivors overcome employment barriers and improve their quality of life through physical activity and mental health support. The legislation specifically addresses disparities in care for racial/ethnic minorities, lower socioeconomic groups, and rural populations who face unique challenges as cancer survivors.
The ARC Act of 2023 establishes a national program to address peripheral artery disease (PAD), which disproportionately affects minority populations and leads to avoidable amputations. The bill requires Medicare and Medicaid to cover PAD screening tests (such as ankle-brachial index testing) for at-risk beneficiaries without cost-sharing, including people 65+ or those with diabetes, smoking history, or other risk factors. It authorizes $6 million annually for a CDC-led education program to inform healthcare providers and the public about PAD prevention and treatment. The bill also creates quality measures to encourage alternative treatments to amputation and establishes a pilot program to test amputation prevention services at healthcare facilities. These provisions aim to reduce amputation rates and improve outcomes for millions of Americans with PAD.
HR 4195, the Empowering Parents’ Healthcare Choices Act of 2021, allows parents to choose which health insurance plan covers their child when both parents have separate, qualifying coverage (e.g., individual policies or employer-sponsored group plans). Specifically, parents must submit a joint notification within 60 days of the child’s birth to designate one plan as primary coverage. This choice remains in effect until parents revoke it or one parent loses coverage under their plan. The bill applies to children born on or after January 1, 2022, and affects families with dual coverage, insurance issuers, and group health plans.
This 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.
HR 3875, the Expanded Telehealth Access Act, expands Medicare coverage for telehealth services by adding new healthcare professionals to the list of providers eligible for payment. It specifically includes licensed audiologists, occupational therapists (and their assistants under supervision), physical therapists (and their assistants under supervision), and speech-language pathologists. The bill ensures these providers are paid the same rate for telehealth services as they would be for in-person care under Medicare. This change directly affects Medicare beneficiaries seeking remote therapy services and the new provider types who can now offer these services via telehealth.
HR 3851, the Access to Breast Cancer Diagnosis Act of 2023, requires most health insurance plans (including group and individual coverage) to cover diagnostic and supplemental breast exams without any out-of-pocket costs like copays or deductibles. This applies to medically necessary exams used to evaluate abnormalities detected during screening (diagnostic) or to screen high-risk individuals without abnormalities (supplemental), following National Comprehensive Cancer Network guidelines. Plans may still require prior authorization for these exams, and state laws providing stronger protections remain in effect. The law takes effect for plan years beginning January 1, 2024.
This bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.
This 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.
The Menstrual Equity For All Act of 2023 requires free menstrual products to be available at no cost in public schools, colleges, correctional facilities, and federal buildings. It makes menstrual products covered by Medicaid, prohibits taxes on these products, and provides funding through social services programs to help low-income individuals access menstrual products. The bill directly affects students (K-12 and college), incarcerated people, homeless individuals, employees (in businesses with 100+ workers), Medicaid beneficiaries, and people receiving Temporary Assistance for Needy Families (TANF). Key provisions include amending school funding to require free products, creating college grant programs for menstrual product distribution, and adding menstrual products to Medicaid coverage and social services programs.
