Rep. Neal P. Dunn

Maddy summaryHR 5391 requires drug manufacturers to pay rebates to Medicare when the price of certain high-cost cancer drugs (called "selected drugs") exceeds a negotiated "maximum fair price" (MFP). This applies to Medicare Part B beneficiaries using these specific drugs, lowering their out-of-pocket costs. The bill mandates manufacturers to calculate rebates based on the difference between current Medicare payment rates (ASP+6) and the new MFP-based rates, reducing beneficiary coinsurance from ASP+6 to MFP+6. The rebates are deposited into Medicare's trust fund and apply to drugs already subject to MFP negotiations under existing law.

Maddy summaryThis bill clarifies that Medicare must cover external infusion pumps and associated non-self-administrable drugs as durable medical equipment (DME) when specific criteria are met. It directly affects Medicare beneficiaries requiring home infusion therapy for drugs that must be prepared just before use, administered by a healthcare professional, or labeled for external pump use at least monthly. Key provisions require the drug's FDA labeling to specify external pump administration, safe home delivery by qualified suppliers, and preparation/administration requirements. The bill mandates Medicare coverage under existing rules (LCD L33794) for qualifying treatments, effective upon enactment or FDA approval, whichever is later.

Maddy summaryThis bill sets strict timelines for Medicare administrative contractors to review requests for local coverage determinations. It requires contractors to determine within 30 days if a request is complete or incomplete, and if incomplete, notify the submitter within 60 days of missing information. For complete requests, contractors must complete research, consult experts, hold a 45-day public comment period, and issue a final decision within 9 months. The bill directly affects Medicare contractors and healthcare providers or entities seeking coverage decisions for Medicare services.

Maddy summaryThis bill changes Medicare billing rules to make remote patient monitoring more accessible. It requires Medicare to cover remote monitoring services with a minimum of 2 days of patient data collected over a 30-day period (instead of the current 16 days), affecting Medicare beneficiaries and healthcare providers. The policy applies to all patients, not just those with COVID-19, and is effective for two years after enactment. The bill also mandates a report to Congress within one year analyzing remote monitoring data and recommending future reimbursement models based on patient needs.

Maddy summaryHR 5208, the Health Care Provider Shortage Minimization Act of 2023, clarifies tax treatment for temporary healthcare workers. It amends the tax code to specify that locum tenens physicians and advanced care practitioners (like nurse practitioners or physician assistants) providing services for up to one year at a single site are not treated as employees for tax purposes. This means the workers themselves, the healthcare facilities hiring them, and payors avoid employer tax obligations related to these temporary services. The bill directly affects temporary healthcare providers and facilities seeking to fill staffing gaps without complex employment tax compliance.

Maddy summaryThis bill modifies the $800 de minimis exemption for small shipments entering the U.S. duty-free. It excludes goods from nonmarket economy countries and nations on the U.S. trade "priority watchlist" from this exemption. Importers must submit detailed documentation (including origin, value, shipper details, and classification) to U.S. Customs within 180 days of enactment. Providing false information could result in $5,000 civil penalties per violation. The changes apply to shipments entered on or after 180 days after the bill’s enactment.

Maddy summaryThe Leveling the Playing Field 2.0 Act (HR 3882) updates U.S. trade law to better address international trade practices that disadvantage American businesses. It establishes special rules for handling multiple investigations of the same merchandise (called "successive investigations"), requiring the Commerce Department to consider previous injury determinations when making new findings. The bill also creates mechanisms to address market distortions from foreign government subsidies, including currency undervaluation, and strengthens procedures to prevent duty evasion through certification requirements for importers. These changes primarily affect foreign exporters of goods subject to U.S. antidumping and countervailing duty investigations, as well as U.S. importers of those goods.

Maddy summaryThis bill establishes "cottage family homes" as a new foster care placement option under federal law. It defines cottage homes as licensed residences caring for up to 2 children per bedroom (with exceptions), requiring trauma-informed care, prohibiting most restraints, and mandating systems for children to report concerns. The bill directly affects foster children placed in these homes and state child welfare agencies, by making cottage homes eligible for federal foster care maintenance payments without time limits. Key provisions include requiring states to adopt the new definition, allowing states flexibility in how they classify these homes, and ensuring children in cottage homes receive the same care standards as those in traditional foster placements.

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.

Maddy summaryHR 3674 increases Medicare payments for specific physician services that rely heavily on equipment and supplies (defined as services where 65%+ of costs are for equipment/supplies). It raises payment rates by 10% in 2024 and 15% in 2025 for these services in non-hospital settings like doctor's offices. The bill funds these increases through federal appropriations to the Medicare Trust Fund. It directly affects physicians and clinics providing those defined services, aiming to stabilize reimbursement for providers of high-cost equipment-dependent care.