Rep. Jerry L. Carl

Maddy summaryThis 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of requiring direct employment), updates the definition of "rural" to exclude areas with 50,000+ residents, and removes outdated lab service requirements by requiring only "prompt access" to clinical labs.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.

Maddy summaryHR 3227, the Ensuring Seniors’ Access to Quality Care Act, amends Medicare and Medicaid rules to address nurse aide training programs in nursing facilities. It allows the Secretary of Health and Human Services to disapprove a facility’s nurse aide training program for up to two years if the facility received a $10,697+ civil penalty for substandard care and hasn’t corrected the quality issues. Facilities can have disapproval lifted by proving they fixed the care deficiencies, haven’t had recent patient harm incidents, and the penalty didn’t involve immediate patient jeopardy. The changes apply only to penalties assessed after the bill’s enactment and do not affect facilities already prohibited under prior rules.

Maddy summaryThis bill regulates pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans. It prohibits PBMs from earning income based on drug prices or rebates (requiring flat fees instead), mandates equal reimbursement for all network pharmacies, and requires PBMs to report how much of drug rebates they pass through to Medicare plans. The law also mandates annual compliance certifications and requires the government to publish aggregated transparency data (without revealing specific plan details) starting in 2024. These changes directly affect Medicare Part D plans and the seniors who rely on them for prescription drug coverage.

Maddy summaryHR 2667, the "Fighting Trade Cheats Act of 2023," increases penalties for importers who commit customs fraud or gross negligence. It triples civil penalties for fraudulent violations (to three times the domestic value) and raises gross negligence penalties to ten times, while adding five-year import bans for fraud and two-year bans for gross negligence. The bill also allows U.S. businesses, unions, or trade groups harmed by such violations to sue violators in federal court for triple damages, attorney fees, and injunctions against further imports. Additionally, it excludes violators and their affiliated companies from the Importer of Record program, with special rules to block shell companies evading customs laws. This directly affects importers who violate customs laws and U.S. businesses competing with those imports.

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 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 summaryHR 497, the Freedom for Health Care Workers Act, eliminates a federal requirement for healthcare workers in Medicare and Medicaid programs to be vaccinated against COVID-19. The bill directly affects healthcare providers who treat patients under these federally funded programs by preventing the enforcement of the November 2021 HHS rule mandating staff vaccinations. Its key provision prohibits the Department of Health and Human Services from implementing, enforcing, or creating a similar rule regarding vaccination for these workers. This bill changes the policy by removing a specific vaccine mandate for providers in Medicare and Medicaid programs.

Maddy summaryThis bill bans federal funding for abortions in most cases, prohibiting the use of taxpayer money for abortion services or health insurance plans covering abortion. Exceptions allow funding for abortions resulting from rape, incest, or when a pregnancy endangers a woman's life. It requires health insurance plans sold through the Affordable Care Act (ACA) marketplaces to clearly disclose any separate costs for abortion coverage and prohibits ACA subsidies from being used for plans that cover abortion (except in the specified exceptions). The law directly affects federal programs like Medicaid, ACA marketplace plans, and insurers offering health coverage to individuals using federal subsidies.