Rep. Yadira Caraveo

Maddy summaryThe HANDS Act requires Medicare, Medicaid, and TRICARE to cover naloxone (an opioid overdose reversal drug) with no out-of-pocket costs when distributed by hospitals to patients identified as at-risk for overdose. It applies to individuals receiving care in hospital emergency departments, inpatient settings, or ambulatory surgical centers, specifically at the time of discharge or when leaving the facility. The bill mandates that providers must determine a patient's overdose risk before distributing naloxone, along with administration instructions. This policy change eliminates cost-sharing barriers for this specific naloxone distribution method, aiming to increase access for vulnerable patients.

Maddy summaryThis bill expands Medicare benefits for chronic kidney disease patients by adding kidney disease screening to annual wellness visits and broadening education options to include more healthcare professionals like nurse practitioners. It updates payment systems to better cover innovative kidney treatments, including new drugs and devices, and requires a study on increasing kidney transplant rates. The bill also aims to improve the kidney care workforce by expanding training opportunities in underserved areas and ensures Medicare Advantage plans properly cover new kidney therapies. These changes directly affect Medicare beneficiaries with kidney disease, dialysis centers, and nephrology providers, with key provisions taking effect in 2022-2024.

Maddy summaryThe Lowering Drug Costs for American Families Act expands Medicare's drug price negotiation program from 20 to 50 drugs, allowing the government to negotiate lower prices for these medications. It requires private health insurance plans and group health coverage to apply these negotiated prices to their members' cost-sharing for covered drugs, with plans able to opt out while publicly disclosing their decision. The bill also extends these negotiated prices to drugs covered by commercial insurance markets, not just Medicare. This would directly affect Medicare beneficiaries and people with private health insurance who take the negotiated drugs.

Maddy summaryThe 9-8-8 Implementation Act of 2023 establishes a national mental health crisis response system centered around the 9-8-8 suicide prevention hotline. It provides $441 million for call center technology, staffing, and operations, and requires Medicare, Medicaid, and private health plans to cover crisis response services including mobile crisis teams and crisis stabilization facilities. The bill also mandates a national suicide prevention media campaign and creates protocols for 9-1-1 dispatchers to better respond to mental health crises. These provisions aim to improve access to mental health crisis care across the United States.

Maddy summaryHR 4475, the Period PROUD Act of 2023, allocates $1.9 billion over four years (2025-2028) through the Social Services Block Grant Program to provide free menstrual products to low-income menstruating individuals. It requires states to distribute funds to qualified nonprofits for direct product distribution, community outreach, and improving access, while limiting administrative costs to 9% of funds. The bill mandates an evaluation by 2030 to assess health impacts and requires annual reports on program effectiveness. It also establishes best practices for schools on discussing menstruation and exempts funding from automatic budget cuts.

Maddy summaryThis bill expands Medicare coverage to include home infusion treatment for people with Alpha-1 Antitrypsin Deficiency Disorder, a genetic condition causing lung and liver damage. It specifically covers "augmentation therapy" (a standard treatment using Alpha-1 Proteinase Inhibitor) when administered in a patient's home by qualified providers. Medicare will pay 80% of the cost for intravenous kits and up to 2 hours of nursing care during these home infusions, starting January 1, 2025. The change directly affects Medicare beneficiaries with this condition who require home-based treatment and their qualified home infusion providers.

Maddy summaryThis bill prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.

Maddy summaryThe Comprehensive Cancer Survivorship Act (HR 4363) establishes new Medicare and Medicaid coverage for cancer care planning and coordination services, requiring personalized survivorship care plans for cancer survivors from diagnosis through the end of life. The bill creates a demonstration program to test different models of survivorship care, including navigation services to help survivors transition from cancer treatment to ongoing care, and mandates Medicaid coverage for cancer fertility services. It also establishes a comprehensive cancer survivorship program with resource centers for survivors and health care providers, and includes provisions to help cancer survivors overcome employment barriers and improve their quality of life through physical activity and mental health support. The legislation specifically addresses disparities in care for racial/ethnic minorities, lower socioeconomic groups, and rural populations who face unique challenges as cancer survivors.

Maddy summaryHR 3851, the Access to Breast Cancer Diagnosis Act of 2023, requires most health insurance plans (including group and individual coverage) to cover diagnostic and supplemental breast exams without any out-of-pocket costs like copays or deductibles. This applies to medically necessary exams used to evaluate abnormalities detected during screening (diagnostic) or to screen high-risk individuals without abnormalities (supplemental), following National Comprehensive Cancer Network guidelines. Plans may still require prior authorization for these exams, and state laws providing stronger protections remain in effect. The law takes effect for plan years beginning January 1, 2024.

Maddy summaryThis bill requires Medicare to cover genetic counseling services provided by licensed genetic counselors at 85% of the physician payment rate. It defines "genetic counselor" as a state-licensed professional (or meeting federal criteria in non-licensing states) and mandates a new billing modifier for these services starting January 1, 2024. Medicare beneficiaries seeking genetic counseling would gain expanded access to these services under this coverage. The policy change applies to services furnished on or after the effective date, with implementation via interim rule.