Rep. Joe Neguse

Maddy summaryHR 1795, the Homecare for Seniors Act, allows seniors to use funds from their Health Savings Accounts (HSAs) to cover qualified home care services. It amends tax law to define "qualified home care" as contracts providing three or more specific personal assistance services (like help with eating, bathing, toileting, or medication) from a licensed provider. The bill directly affects seniors with HSAs who need in-home care, expanding their tax-free distribution options beyond traditional medical care. It also requires the federal government to run a public awareness campaign about these new eligible home care expenses. The changes apply to expenses paid after the bill's enactment date.

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 summaryThe Prevent Interruptions in Physical Therapy Act of 2023 amends Medicare rules to allow physical therapists to use temporary replacement providers (locum tenens) for outpatient physical therapy services, aligning with existing provisions for physicians. This directly affects Medicare beneficiaries receiving physical therapy and physical therapy practices needing temporary staffing solutions during provider shortages. The bill updates the Social Security Act to extend the current physician locum tenens rule to physical therapists, ensuring continuity of care without requiring separate approval for temporary coverage. It applies to services furnished after the bill's enactment date.

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 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.

Maddy summaryThis bill makes permanent Medicare coverage for cardiac and pulmonary rehabilitation services delivered via telehealth in patients' homes, which were temporarily allowed during the pandemic. It removes geographic restrictions that previously required in-person visits or limited services to specific locations like clinics. The change directly affects Medicare beneficiaries needing heart or lung rehabilitation and healthcare providers offering these programs. It ensures home-based telehealth visits for cardiac, intensive cardiac, and pulmonary rehabilitation receive the same coverage as in-clinic services under Medicare.

Maddy summaryHR 1110, the KEEP Telehealth Options Act of 2023, requires the Department of Health and Human Services (HHS) to study pandemic-era telehealth expansions in Medicare, Medicaid, and CHIP programs through December 2024. The bill mandates HHS to report on telehealth service availability, provider reimbursement rules, usage patterns (including by rural, minority, low-income, and elderly populations), and mental health service use. It also directs MedPAC and MACPAC to study access barriers and potential fraud risks in telehealth services during this period. The reports, due within 1-18 months, will inform future policy decisions about telehealth coverage. This legislation focuses on gathering data to evaluate existing telehealth policies, not on changing them.

Maddy summaryHR 957, the Public Safety Retirees Healthcare Protection Act of 2023, increases a tax exclusion for public safety retirees. It amends the Internal Revenue Code to raise the amount excluded from taxable income for health and long-term care insurance premiums paid from retirement distributions - from $3,000 to $6,000 annually. This change directly affects public safety officers (like police and firefighters) who have retired and receive government retirement benefits. The provision applies to taxable years beginning after December 31, 2023, providing greater tax relief for these retirees' healthcare costs.

Maddy summaryThe Stop the Wait Act of 2023 eliminates the current 5-month waiting period for Social Security Disability Insurance (SSDI) benefits by phasing it out: applications filed in 2023-2025 would face a 3-month wait, 2026 a 2-month wait, and 2027 a 1-month wait, with full elimination by January 2028. It also changes Medicare rules to allow individuals without minimum essential health coverage to receive Medicare benefits retroactively from the first month of SSDI eligibility, rather than waiting 24 months. This directly affects people under 65 applying for SSDI who lack other health insurance, ensuring they have coverage during the waiting period. The bill amends the Social Security Act to implement these changes, effective January 1, 2028.

Maddy summaryThis bill changes how Medicare pays for certain outpatient services provided by off-campus hospital departments. It allows these services to be paid under the hospital outpatient payment system (instead of physician fees) if the previous year's total Medicare payments for that physician specialty were under $2 million. It directly affects hospitals with off-campus outpatient departments offering services in specialties with low physician payment volumes. The change applies to services furnished starting in 2024, aiming to stabilize payments for these specific outpatient services.