Rep. Jason Crow

Maddy summaryThe PASTEUR Act establishes a new subscription payment model to incentivize development of new antimicrobial drugs for resistant infections. It creates a Committee on Critical Need Antimicrobials and a Subscription Contract Office to manage payments based on specific drug characteristics like treating multi-drug resistant infections, novel mechanisms of action, and oral administration. Under this model, the government would pay drug developers up to $3 billion over 10 years for qualifying drugs, with payments tied to requirements like ensuring drug availability, reporting resistance data, and developing appropriate use plans. The bill aims to address the lack of new antimicrobial drugs by changing the funding model to reward drugs that meet specific clinical and public health needs.

Maddy summaryThis bill establishes a new workplace violence prevention standard for healthcare and social service workers. It requires employers in covered facilities - including hospitals, nursing homes, mental health clinics, and social service settings - to develop and implement comprehensive prevention plans with specific requirements. These plans must include risk assessments, hazard prevention measures, employee training on violence prevention, and procedures for reporting and investigating violent incidents. The bill also amends Medicare regulations to require compliance with these standards for hospitals and skilled nursing facilities receiving Medicare funds.

Maddy summaryThe PROTECT 340B Act of 2023 prohibits pharmacy benefit managers (PBMs), health insurance plans, and health insurance issuers from discriminating against healthcare providers participating in the 340B drug pricing program. It specifically bans these entities from paying less for 340B drugs than they would for similar drugs dispensed by non-340B providers, imposing special requirements on 340B providers, or requiring identification of 340B drugs in billing. The bill establishes civil penalties of up to $5,000 per violation per day for PBMs that violate these protections and requires the Health Resources and Services Administration to create implementing regulations. It directly affects safety-net hospitals, clinics, and health centers that serve low-income patients, particularly those in rural areas, by protecting their ability to use 340B drug discounts to provide affordable care.

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 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 summaryThis bill requires Medicare, Medicaid, and CHIP to cover advanced genetic cancer testing (like DNA/RNA sequencing and their interpretation) for patients diagnosed with cancer. It defines covered tests as next-generation sequencing performed by clinical labs and limits coverage to once per diagnosis, recurrence, or treatment monitoring. Medicare will pay 80% of the test cost (or 100% if billed under assignment), while Medicaid and CHIP must include these tests in mandatory coverage starting January 1, 2025. The bill directly affects cancer patients enrolled in these federal health programs by ensuring access to specific genetic testing without excessive out-of-pocket costs.

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.