Rep. Gus M. Bilirakis

Maddy summaryHR 6417 amends the existing "Ending Importation of Russian Oil Act" to ban imports of energy products (classified under Harmonized Tariff Schedule chapter 27) produced at any refinery using crude oil originating in Russia. This directly affects U.S. importers and companies bringing in such refined petroleum products. The key provision prohibits these imports regardless of where the refinery is located, targeting oil that has been "laundered" through foreign processing. The bill updates the existing law by adding this origin-based import ban as a new section.

Maddy summaryThis bill amends Medicare, Medicaid, and private insurance rules to improve coverage for drugs treating rare diseases (defined as conditions affecting 200,000 or fewer people in the U.S.). It requires coverage for rare disease drug uses supported by peer-reviewed medical literature and not listed as contraindicated in FDA labeling or medical reference guides. Private insurers must provide expedited review processes for denials of such drugs. The changes apply 30 days after enactment, affecting insurers and patients seeking coverage for rare disease treatments.

Maddy summaryHR 5819, the COMPLETE Care Act, incentivizes Medicare primary care providers to integrate behavioral health services by increasing payments for specific services (like mental health and substance use disorder support) during 2025-2027. Providers using designated HCPCS codes for integrated care would receive 125-175% of standard payment rates, with the percentage declining annually. The bill also requires these providers to report on integration quality measures and mandates technical assistance for practices adopting integrated models, funded through new appropriations for 2024-2027. It directly affects Medicare-participating primary care practices serving beneficiaries needing mental health or substance use services.

Maddy summaryThis bill would allow Medicare Advantage plans to offer more supplemental benefits to certain high-need enrollees starting in 2025. It defines "specified enrollee" to include people with life-threatening chronic conditions requiring intensive care coordination, low-income beneficiaries, or those facing significant social/socioeconomic risks. The change modifies Medicare Advantage rules to expand eligibility for these supplemental benefits beyond current categories. The law directly affects Medicare Advantage enrollees meeting these new criteria, not the general Medicare population.

Maddy summaryThe DRA of 2023 adjusts Medicare payment rates for specific durable medical equipment (DME) items that were part of the 2021 competitive bidding program but for which no supplier contracts were finalized. It directly affects DME suppliers and Medicare beneficiaries by establishing a new 2024 payment formula: 90% of the adjusted payment amount plus 10% of the unadjusted fee schedule for eligible items. The bill also extends a temporary transition rule for non-rural areas through December 31, 2024, while delaying a regulatory change until 2025. These provisions aim to stabilize payments for DME items that did not transition to standard pricing under prior rules.

Maddy summaryThe ORPHAN Cures Act amends the Drug Price Negotiation Program under the Social Security Act to clarify how orphan drugs (medications for rare diseases affecting fewer than 200,000 people in the U.S.) are treated. It ensures that periods when a drug was designated as an orphan drug are excluded from the time calculation used to determine when the drug can no longer be excluded from price negotiations. The bill also updates the definition to allow a single drug to be designated for multiple rare diseases, rather than just one. This change provides clearer rules for manufacturers and the government regarding orphan drug exclusions in the program.

Maddy summaryThe Cutting Copays Act lowers prescription drug costs for low-income Medicare Part D beneficiaries. Starting in 2024, generic drugs will have a $0 copay, while other drugs will have a copay set at the 2023 level (adjusted for prior changes) and then increased annually by the consumer price index. For 2023 and earlier, the maximum copay for generic drugs was $1 and for other drugs was $3. This directly reduces out-of-pocket expenses for millions of low-income seniors and people with disabilities enrolled in Medicare Part D.

Maddy summaryHR 5371, the Choices for Increased Mobility Act of 2023, updates Medicare payment rules for manual wheelchairs. It clarifies that Medicare Part B will not cover the extra cost of titanium or carbon fiber materials in a wheelchair's base, effective January 1, 2023. This specifically affects Medicare beneficiaries who use manual wheelchairs with these materials, as payments will now be calculated without including those component costs. The bill directly changes how Medicare reimburses providers for such wheelchairs by excluding these materials from the standard payment amount. This is a technical adjustment to Medicare's fee schedule, not a new benefit or eligibility change.

Maddy summaryThe Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.

Maddy summaryHR 4752 (the CHANGE Act of 2023) requires Medicare to include standardized cognitive impairment screening during annual wellness visits and initial preventive physical exams for beneficiaries starting in 2024. It mandates doctors use National Institute on Aging-approved tools to detect memory issues and document results in medical records. This directly affects Medicare patients aged 65+ and their healthcare providers, aiming to enable earlier Alzheimer’s diagnosis and care planning. The bill focuses on making routine screenings a standard part of Medicare-covered checkups, not on funding or new programs. It does not alter existing Medicare benefits but adds a specific screening requirement to two existing service categories.