Rep. Mariannette Miller-Meeks

Billion Dollar Boondoggle Act This bill requires the Office of Management and Budget (OMB) to collect information from federal agencies and report to Congress regarding projects that are behind schedule or have expenditures that have exceeded the original cost estimate.  Specifically, the bill requires OMB to issue guidance directing federal agencies to annually submit specified information to OMB regarding certain federally funded projects that (1) are more than five years behind schedule, or (2) have expenditures that are at least $1 billion more than the original cost estimate for the project.  Among other information, the agencies must submit to OMB a description of each project; an explanation of any change to the original scope of the project; the original and current expected dates for the completion of the project; the original and current cost estimates adjusted for inflation;  an explanation for any delays in completing the project or increases in the cost; and the amount of and rationale for any award, incentive fee, or other type of bonus awarded for the project. The bill also requires OMB to submit an annual report to Congress containing the information submitted by the agencies and post the report on the OMB website. The report must be submitted in unclassified form, but may include a classified annex.

Maddy summaryThe Prices on the Wall Act of 2026 requires hospitals, ambulatory surgical centers, laboratories, and imaging providers across the United States to display specific pricing information on their walls starting in 2028. This law mandates that these facilities post discounted cash prices for a list of services designated by the Centers for Medicare & Medicaid Services, or if those prices are unavailable, the median amount charged to self-pay patients over the previous three years. The displayed prices must be located in areas specified by the Secretary of Health and Human Services to ensure patients can see costs before receiving care. By making these financial details publicly visible, the bill aims to increase price transparency for consumers seeking scheduled medical services.

Maddy summaryHR 2004, titled "Tyler’s Law," requires the Secretary of Health and Human Services to study how often hospital emergency departments test for fentanyl during overdose cases (beyond standard drug tests), including associated costs, patient benefits/risks, and impacts on privacy and patient-physician relationships. The study must be completed within one year of the bill's enactment. Based on the study results, the Secretary must issue guidance within six months on whether emergency departments should routinely test for fentanyl, how to inform clinicians about test contents, and how such testing may affect future overdose risks and health outcomes. This bill directly affects hospital emergency departments and patients experiencing overdoses by shaping future testing protocols.

Maddy summaryHR 1266, the Combating Illicit Xylazine Act, adds xylazine - a veterinary sedative increasingly found in illicit drug mixtures - to Schedule III of the Controlled Substances Act, regulating its use and trafficking. It directly affects veterinarians, animal owners, and manufacturers by allowing xylazine to be legally dispensed for animal use under specific veterinary prescriptions, while prohibiting non-veterinary human use. The bill includes transition periods (60 days for practitioners, 1 year for labeling) to ease compliance for manufacturers and practitioners, and requires the DEA and FDA to expedite necessary applications. It also mandates two congressional reports on xylazine's illicit use and trafficking patterns, and directs the Sentencing Commission to review penalties for offenses involving xylazine.

Maddy summaryThe Conversational AI Services Act establishes new safety and transparency rules specifically for companies offering chatbot services to users under 18. It requires operators to clearly inform minors that they are interacting with artificial intelligence and prohibits the use of unpredictable rewards to encourage excessive engagement. The bill also mandates that these services cannot generate sexually explicit content, falsely claim to be human or sentient, or simulate romantic relationships with minors, while also requiring tools for parents to manage screen time. Additionally, the law compels chatbots to provide crisis resources when users discuss self-harm and forbids them from pretending to offer professional mental health advice. The Federal Trade Commission is designated to enforce these provisions, with the rules taking effect one year after the bill is enacted.

Maddy summaryThe Take Care of America's Veterans Act is a comprehensive legislative bill designed to improve benefits, healthcare access, and administrative efficiency for veterans and their families. The bill directly affects veterans, their surviving spouses, caregivers, and the Department of Veterans Affairs (VA). Key provisions include expanding disability compensation for combat-related retirees, allowing remarried surviving spouses to retain certain survivor benefits, and increasing compensation rates for specific disability conditions like sleep apnea and tinnitus. The legislation also mandates significant healthcare improvements, such as establishing a pilot program to coordinate care between the VA and Medicare, creating a formulary for prosthetic items, and requiring the VA to provide lactation spaces in all medical centers. Additionally, the bill introduces administrative reforms to speed up claims processing, prohibit denying claims solely for missed medical appointments, and enhance oversight of the VA's disability rating system.

Maddy summaryThe Patients First Act of 2026 modifies how Medicare reimburses physicians and primary care providers to improve access and stabilize payments. It establishes a new hybrid payment model for primary care services from 2027 to 2031, which pays a monthly fee per patient to eligible independent practices while covering specific services like care management and telehealth without cost-sharing for patients. The bill also updates the formula for calculating reimbursement rates to account for high inflation years and requires more frequent updates to the costs used in calculating payments. Additionally, the legislation reforms the performance-based payment system by adding care efficiency measures, creating a task force to recommend new quality metrics, and adjusting penalties for providers who fail to report on certain data.

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic pre-approval systems for medical services by 2028 and meet transparency reporting standards starting in 2027. Plans must publicly report data on approval/denial rates, appeal outcomes, response times, and technology use for pre-approval requests, including details on how denials relate to clinical criteria. It establishes a 24-hour response timeframe for certain requests and mandates annual reviews of pre-approval requirements based on data and input from seniors and providers. The law directly affects Medicare Advantage plans, seniors enrolled in these plans, and healthcare providers who submit pre-approval requests. These changes aim to make the pre-approval process faster, more transparent, and more accountable for seniors seeking covered medical services.

Maddy summaryThe Cure Hepatitis C Act of 2026 establishes a federal program to eliminate hepatitis C by creating a subscription model that allows the government to purchase antiviral drugs directly from manufacturers and distribute them at no cost to specific patient groups. These groups include individuals in Medicaid or CHIP programs, those without health insurance, patients in correctional facilities, and those receiving care through the Indian Health Service. The bill also expands Medicare coverage by removing deductibles and copayments for hepatitis C treatments between 2028 and 2032. To support these efforts, the legislation authorizes funding for state grants to improve screening and treatment access, mandates the creation of a national strategy and performance dashboard, and requires coordination with various federal agencies and stakeholders.

Maddy summaryThe BRACE Act updates federal regulations to improve how lithium-ion batteries are managed and recycled in the United States. It requires facilities that store these batteries before recycling them to follow stricter safety and record-keeping rules similar to those for large industrial waste handlers. Additionally, the bill modernizes existing laws by replacing outdated references with current environmental protection standards. These changes directly impact businesses and organizations involved in the collection, storage, and recycling of lithium-ion batteries.