Rep. Debbie Lesko

Maddy summaryThis bill prohibits federal criminal prosecution for performing "gender-related medical treatment" on minors under specific circumstances, defined as medical procedures or medications intended to change a minor's gender presentation (e.g., puberty blockers, surgeries like hysterectomy or phalloplasty). Exceptions apply for medically necessary treatments for disorders of sex development, ambiguous biological characteristics, or injuries from prior treatments. It also bans Medicare coverage for such treatments (except for the medical exceptions) and prohibits federal funding for any gender-related medical care for minors. The bill directly affects minors seeking gender-affirming care, healthcare providers offering these treatments, and federal health programs like Medicare.

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.

Maddy summaryThis bill amends Medicare rules to permanently exclude from the program any provider who prescribes, administers, dispenses, or furnishes abortion-inducing drugs via telehealth without meeting four specific requirements: being a physician, physically examining the patient, being present in the same room during drug administration, and scheduling an in-person follow-up within 14 days. It directly affects Medicare providers offering telehealth abortion services that don't comply with these in-person conditions. The law defines "abortion-inducing drug" broadly as any substance prescribed to terminate a pregnancy with knowledge it will likely cause fetal death. Providers failing to meet these conditions face permanent Medicare exclusion, with no exceptions for telehealth services.

Maddy summaryThis bill modifies Social Security Number (SSN) requirements for claiming the Child Tax Credit and Earned Income Tax Credit. It specifies that qualifying SSNs must be issued to U.S. citizens (or under specific Social Security Act provisions) and issued before the tax return due date. The changes apply to tax years beginning after December 31, 2024, and update related tax code references to use "social security number" instead of "taxpayer identification number." These are technical adjustments to eligibility criteria, not new benefits or funding.

Maddy summaryHR 7427 clarifies that states may use Temporary Assistance for Needy Families (TANF) funds to support pregnancy centers and other "alternatives to abortion" programs that provide life-affirming services like counseling, parenting resources, and material support to pregnant individuals. The bill explicitly defines these programs as those promoting childbirth over abortion through services such as prenatal care coordination, job training, infant supplies, and adoption referrals, while excluding entities that provide or facilitate abortions. It also prohibits federal discrimination against grantees or states that fund such programs, including preventing the government from imposing unfair requirements or cutting funding based on a provider's opposition to abortion. This bill directly affects pregnancy centers, adoption agencies, and maternity homes receiving TANF funding, ensuring their eligibility under existing federal law. The legislation responds to a 2023 federal proposal that threatened to restrict such funding.

Maddy summaryThis bill protects religious child welfare providers from losing government contracts or funding if they refuse to provide services conflicting with their sincerely held religious beliefs (e.g., certain foster care or adoption placements). It prohibits states and federal agencies from denying contracts, licenses, or renewals for this reason, and allows providers to sue for violations with recovery of damages and legal fees. States violating the law risk losing 15% of federal child welfare funding. The law applies to all federally funded child welfare services, including foster care, adoption support, and family preservation programs.

Maddy summaryHR 5107, the Pandemic Unemployment Fraud Recoupment Act, extends the statute of limitations for enforcing fraud related to pandemic unemployment benefits from 3 years to 10 years across multiple programs, including Pandemic Unemployment Assistance, Federal Pandemic Unemployment Compensation, and Lost Wages Assistance. It requires states to recover overpayments from individuals who knowingly received benefits they weren’t entitled to, through deductions from future unemployment benefits, while maintaining existing due process protections like hearings before repayment. States may waive repayment if the overpayment wasn’t the individual’s fault or if repayment would be unfair. The bill applies directly to individuals who received pandemic-era unemployment benefits through fraudulent means, ensuring states have a longer timeframe to address these cases under established fraud procedures.

Maddy summaryThis bill prevents Medicare from imposing stricter supervision requirements for outpatient physical therapy and occupational therapy than those established by state law, requiring Medicare to follow existing state regulations instead. It takes effect January 1, 2024, directly affecting Medicare-covered therapy services in all states. Additionally, it mandates a Government Accountability Office study by December 2024 to analyze how Medicare’s 15% payment differential for therapy assistants impacts access to care in rural and underserved areas. The study will examine this payment policy across all Medicare Part B settings.

Maddy summaryHR 4473, the Medicare Patient Access to Cancer Treatment Act, requires Medicare to pay the same rate for cancer care services whether provided in a hospital outpatient department or a physician’s office. It directly affects Medicare beneficiaries receiving cancer treatment and healthcare providers (hospitals and physician offices) who deliver cancer care services. The bill mandates equal reimbursement for defined cancer care services - such as chemotherapy administration and cancer diagnosis/treatment - starting in 2025, eliminating current higher payments for hospital settings. This change aims to reduce unnecessary cost increases for Medicare (estimated $615 million added between 2015-2019 due to current payment disparities) without altering care quality.

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.