Rep. Neal P. Dunn

Maddy summaryThe Preserving Seniors’ Access to Physicians Act of 2023 increases the Medicare payment adjustment rate for physicians from 1.25% to 4.62%, directly affecting doctors who treat Medicare patients (primarily seniors). It also reduces the funding for the Medicaid improvement fund from $5,796,117,810 to $3,973,117,810. These changes impact Medicare providers and Medicaid programs, with the Medicare adjustment aimed at supporting physicians adjusting to payment changes. The bill does not specify how the Medicaid funding reduction relates to its stated goal of preserving seniors' access to physicians.

Maddy summaryHR 6369 extends Medicare incentive payments for healthcare providers participating in "eligible alternative payment models" (APMs), which are alternative Medicare payment structures for doctors and clinics. The bill updates payment rules to cover 2026 instead of 2025, adding a new rule that reduces 2026 payments by 34% for providers in their 4th-6th year of APM participation and by 67% for those in their 7th year or longer. These changes directly affect Medicare-certified healthcare professionals and organizations enrolled in APMs, altering their payment incentives based on years of participation. The bill amends Section 1833(z) of the Social Security Act to adjust payment timelines and reduction percentages, with related updates to other Medicare payment provisions.

Maddy summaryThis bill prevents Medicare from publicly disclosing a physician's or practitioner's home address if they provide telehealth services from home and the address is required for enrollment or billing. It directly affects doctors and healthcare providers who choose to deliver telehealth services from their residences. The key provision amends Medicare rules to ensure that even when an address is needed for administrative purposes, the home location remains private and cannot be shared publicly. This is a specific privacy safeguard, not a broad policy change to telehealth services.

Maddy summaryThis bill updates Medicare physician payment rules to improve stability and accuracy. It raises the budget neutrality threshold from $20 million (pre-2025) to $53 million in 2025, with annual indexing after 2026, to prevent excessive payment adjustments. The bill requires the Medicare program to correct budget neutrality payments based on actual service utilization data (not estimates) starting in 2025, and mandates updating direct cost inputs (like staff wages and equipment prices) every 5 years. It also caps annual changes to the physician payment conversion factor at 2.5% to limit sudden payment shifts, directly affecting Medicare physicians and healthcare providers receiving these payments.

Maddy summaryHR 6283, the DRUG Act, regulates pharmacy benefit managers (PBMs) to prevent practices that may increase prescription drug costs for consumers. The bill prohibits PBMs from earning revenue based on drug prices or discounts, requiring them to charge flat dollar service fees instead of fees tied to drug costs. It bans PBMs from steering patients to pharmacies they own or control, mandates equal reimbursement for affiliated and non-affiliated pharmacies, and prohibits charging different fees for the same drug. These provisions apply to group health plans, health insurance issuers, and PBMs, with enforcement beginning for plan years starting January 1, 2026. Violations would result in $10,000 daily penalties and require disgorgement of improperly received payments.

Maddy summaryThe Maximum Pressure Act (HR 6114) is a legislative proposal that would maintain and expand U.S. sanctions against Iran. The bill would codify existing sanctions, require Iran to meet 12 specific conditions before sanctions could be lifted (including ending support for terrorism, releasing hostages, and ending nuclear enrichment), and expand sanctions on Iran's Revolutionary Guard Corps and missile programs. It also establishes new reporting requirements for the U.S. government to monitor Iran's activities and the impact of sanctions. The legislation would require congressional review before any sanctions could be lifted or modified, preventing the executive branch from unilaterally easing restrictions.

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 5967, the Unemployment Integrity Act of 2023, requires unemployment claimants to participate in job-seeking activities to maintain benefits. Specifically, it mandates that claimants respond to work-related requests, attend reemployment interviews, and comply with reasonable requests like drug testing or skills assessments. The bill also requires states to conduct a study on increasing random audits of unemployment claims and mandates that states adopt these new requirements to receive federal funds for extended unemployment benefits. These changes apply to weeks beginning one year after the bill's enactment, with adjustments for states holding biennial legislative sessions. The law directly affects individuals claiming unemployment benefits by linking eligibility to active job-seeking participation.

Maddy summaryThe Maintaining Investments in New Innovation Act (HR 5547) extends the exclusivity period for certain advanced drugs from 7 to 11 years. It defines an "advanced drug product" as a drug using genetically targeted technology to change how genes work, such as drugs that suppress or activate gene function. The bill amends the Social Security Act to update the definition of "qualifying single source drug" to include these advanced therapies with the longer exclusivity period. This change directly affects drug manufacturers developing such advanced therapies and influences Medicare's drug coverage rules by delaying generic competition for these specific treatments.

Maddy summaryThis bill requires Medicare Part D drug plans (which cover seniors' prescription drugs) to include all cheaper generic drugs and at least two cheaper biosimilars in a "preferred" formulary position starting in 2024. Specifically, plans must list these lower-cost options on a tier with lower patient costs than the original brand-name drug, and cannot impose stricter access rules (like prior authorization) on them compared to the brand-name drug. It directly affects Medicare Part D sponsors and seniors enrolled in these plans by mandating more affordable drug options. The key change is requiring formulary placement and cost-sharing for specific lower-cost generics and biosimilars, without restricting patient access to them relative to brand-name alternatives.