Rep. Nanette Diaz Barragán

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

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 summaryThe Access to Innovative Treatments Act of 2023 creates a new process for Medicare to review coverage denials or limitations for FDA-approved drugs and biologicals. It requires Medicare to conduct a 30-day review of such decisions, including a 30-day public comment period, and issue a final decision within 30 days of the comment period, with transparency about evidence and public input. The bill also prohibits Medicare from applying outdated coverage decisions to newly approved drugs that would deny coverage inconsistent with FDA approval. This directly affects Medicare beneficiaries seeking coverage for innovative treatments and Medicare Part D plans managing drug coverage.

Maddy summaryThis bill modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

Maddy summaryHR 1692, the Health Care Affordability Act of 2023, adjusts how health insurance subsidies are calculated for people buying coverage through the marketplace. It replaces the previous subsidy formula with a sliding scale based on income, where households earning up to 150% of the poverty line pay 0% of premiums, and those at 400% or more pay 8.5%. The change applies to all income tiers between these points, with percentages increasing incrementally (e.g., 2% for 150-200% income). This directly affects individuals purchasing health insurance through the marketplace who qualify for subsidies under the Affordable Care Act. The bill amends Section 36B of the Internal Revenue Code and takes effect for tax years beginning after December 31, 2022.

Maddy summaryThe E-BIKE Act establishes a 30% tax credit for individuals purchasing qualified electric bicycles, with a maximum credit of $1,500 per bicycle (30% of the $5,000 cost limit). To qualify, bicycles must meet specific safety standards including speed limits (20 mph for classes 1-2, 28 mph for class 3), pedal assistance requirements, and safety certifications like UL 2849. The credit phases out for higher-income taxpayers, beginning at $150,000 modified adjusted gross income for single filers, $225,000 for heads of household, and $300,000 for joint filers. The bill also includes a provision allowing retailers to claim the credit directly when selling qualifying bicycles, reducing the upfront cost for consumers.

Maddy summaryThis bill increases Medicare reimbursement for clinical social workers from 75% to 85% of the payment rate for psychologists under Part B. It also removes an exclusion that previously prevented skilled nursing facilities from billing Medicare for social worker services provided to residents. The bill expands covered services to include specific mental health assessments and interventions identified by HCPCS codes (like 96156, 96158-96161, etc.) for Medicare beneficiaries. These changes take effect for services provided on or after January 1, 2024, directly affecting Medicare patients and clinical social workers.

Maddy summaryThe HELLPP Act (HR 1634) amends Medicaid to recognize doctors of podiatric medicine (podiatrists) as physicians, enabling them to be reimbursed for services under Medicaid starting January 1, 2024. It also clarifies Medicare’s documentation requirements for therapeutic shoes for people with diabetes, mandating specific written certifications from a managing physician and a podiatrist to confirm medical necessity. These changes directly affect patients with foot conditions, especially those with diabetes, by improving access to podiatrist-provided care and coverage for therapeutic shoes. The bill includes a separate provision strengthening Medicaid program integrity through continuous levies on provider payments, but this does not alter patient coverage. All key provisions take effect on January 1, 2024.

Maddy summaryThe Affordable Insulin Now Act (HR 1488) requires health insurance plans and issuers to cover specific insulin products with cost-sharing capped at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, starting in 2024. It directly affects people with diabetes who rely on insulin by limiting out-of-pocket costs for covered products. The bill mandates coverage of all insulin types (rapid-acting, long-acting, etc.) and dosage forms (vials, pumps, etc.) as selected by the plan. This applies to both group and individual health insurance plans under the Public Health Service Act, Internal Revenue Code, and ERISA, with cost-sharing counting toward annual deductibles.

Maddy summaryThis bill expands Medicare coverage for hereditary cancer prevention and management. It requires Medicare to cover genetic testing for individuals with a personal or family history of hereditary cancer mutations, as defined by evidence-based guidelines from organizations like the National Comprehensive Cancer Network. The bill also mandates coverage for risk-reducing surgeries (like mastectomies or oophorectomies) when medically appropriate, and increases the frequency of recommended cancer screenings (such as mammograms, colonoscopies, and breast MRI) to at least annually for those with confirmed hereditary cancer gene mutations. These changes apply to Medicare beneficiaries with specific hereditary cancer risk factors, effective upon the bill's enactment.