Rep. Sheila Cherfilus-McCormick

Maddy summaryThis bill would expand Medicare Part D coverage to include FDA-approved weight loss medications for dual-eligible beneficiaries (those enrolled in both Medicare and Medicaid), directly affecting approximately 12.5 million low-income Americans. It removes current coverage barriers by amending Medicare rules to require Part D plans to cover these medications for obesity treatment or weight loss management starting in 2026. This change would significantly reduce out-of-pocket costs for beneficiaries - from $900-$1,350 per month to as little as $25 monthly - based on existing cost data. The policy aims to address high obesity-related healthcare costs ($173 billion annually) while targeting a population where 38% of Medicaid and 48% of Medicare beneficiaries are affected by obesity.

Maddy summaryThis bill extends Medicare payment adjustments for physicians and other practitioners through 2025 instead of ending in 2024. It specifically adds a 4.73% payment increase for services provided between January 1, 2025, and January 1, 2026. The legislation modifies existing Medicare payment rules to stabilize practice revenues during transition periods. It directly affects doctors and healthcare providers who bill Medicare for patient services. The key change is the extended timeframe and the defined 4.73% rate for the 2025-2026 period.

Maddy summaryThis bill requires Medicare providers to inform patients about breast reconstruction coverage before performing a mastectomy. Specifically, it mandates that providers must tell patients their Medicare coverage includes breast reconstruction surgery following a medically necessary mastectomy (covered under Medicare's existing national policy 140.2) and document this discussion in the patient's medical record. The requirement applies to all mastectomies performed on or after one year after the bill's enactment. It directly affects Medicare beneficiaries undergoing mastectomies and the healthcare providers who perform these procedures, ensuring patients are aware of existing coverage options. The bill does not change Medicare's coverage rules but ensures patients receive clear information about available benefits.

Maddy summaryThe Patient Debt Relief Act requires Medicare-participating hospitals to establish clear financial assistance policies by January 2026, including publicly available eligibility criteria and 30-day pre-payment screening for charity care. It prohibits hospitals from placing home liens, garnishing wages, or selling debt to collectors without offering income-based repayment plans (capping payments at 4% of gross monthly income) and eliminates interest for patients earning under 250% of the poverty line. Hospitals failing to comply face civil penalties up to $1 million per violation. The bill also creates a $100 million grant program to fund nonprofits that discharge medical debt for individuals meeting income thresholds (5% of income or under 400% of poverty line), with quarterly reporting requirements. These provisions apply directly to hospitals and low-income patients with medical debt.

Maddy summaryThe Pharmacists Fight Back Act (HR 9096) sets new rules for Pharmacy Benefits Managers (PBMs) working with federal health care programs like Medicare Part D and Medicaid. It requires PBMs to reimburse in-network pharmacies at a rate covering the drug's actual cost plus a small fee (capped at $25), and to reduce patient cost-sharing by at least 80% of rebates received from drug manufacturers. The bill bans PBMs from steering patients to specific pharmacies, charging patients more than pharmacies are paid, or using rebates to lower pharmacy payments after claims are processed. It also mandates public reporting of drug pricing data to improve transparency, ensuring patients and pharmacies receive fairer treatment under federal health programs.

Maddy summaryHR 8796, the "Stop Comstock Act," removes outdated restrictions from federal law that previously banned the distribution of materials related to contraception and abortion as "obscene" or "indecent." The bill amends Title 18 and the Tariff Act by deleting references to "indecent," "immoral," "unlawful abortion," and "procuring abortion" from provisions governing obscene materials. It clarifies that the law only prohibits "obscene materials" in commerce, eliminating broad restrictions on reproductive health information. This directly affects internet platforms, healthcare providers, and individuals sharing reproductive health resources by removing legal barriers to their distribution.

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.

Maddy summaryThe Ensuring Excellence in Mental Health Act (HR 8543) establishes a permanent Medicaid payment system for Certified Community Behavioral Health Clinics (CCBHCs) and adds their services to Medicare coverage. It creates a new Medicaid payment system that calculates payments based on clinic costs with annual inflation adjustments, and sets Medicare reimbursement at 80% of the lesser of actual charges or determined amounts. The bill also creates a new grant program providing $552.5 million annually from 2024-2028 to support CCBHC operations, with specific certification requirements including 24/7 crisis services, sliding scale fees, and care coordination across providers. The legislation requires clinics to meet new certification standards and establishes a data collection system to track clinic performance.

Maddy summaryThe ASTIP Act of 2024 establishes a U.S. strategy to strengthen trade and investment ties between the United States and African countries through the African Continental Free Trade Area (AfCFTA). It requires the President to submit an initial report within 270 days detailing a strategy with specific goals for expanding U.S. exports, supporting manufacturing growth, and improving digital trade infrastructure, with annual updates and a final report due 10 years later. The bill authorizes $50 million annually for a trade capacity building program to help African countries implement the AfCFTA, with a focus on supporting women-owned businesses, small enterprises, and modernizing customs procedures. The strategy must include measurable goals and address barriers to trade, while promoting inclusive economic growth across Africa.

Maddy summaryHR 7555, the RETRO GSP Act, requires the U.S. government to refund over $3 billion in tariffs paid by American businesses on imports from beneficiary countries during the GSP program's lapse (Dec 31, 2020-enactment date). It directs U.S. Customs to retroactively treat qualifying import entries as if they occurred on Dec 31, 2020, allowing businesses to get tariff refunds. Companies must submit refund requests to Customs within 180 days of the bill's enactment, with payments due within 90 days of processing. This directly affects U.S. importers of goods from GSP-eligible countries who paid duties during the program's suspension.