Rep. Darren Soto

Maddy summaryThe Telehealth Modernization Act of 2024 extends Medicare's temporary telehealth coverage rules permanently, removing the previous 2024 expiration date. It expands who can provide telehealth services by allowing more healthcare professionals (like certain nurse practitioners) to bill Medicare for these services, and ensures Federally Qualified Health Centers and Rural Health Clinics can continue billing for telehealth under existing payment rules after 2024. The bill also explicitly permits audio-only telehealth calls for Medicare coverage and allows telehealth for hospice face-to-face visits and home dialysis assessments as clinically appropriate, without time limits. These changes directly affect Medicare beneficiaries, healthcare providers, and community health centers offering telehealth services.

Maddy summaryThis bill requires Medicare to cover falls risk assessments and fall prevention services during annual wellness visits and initial preventive physical exams for seniors aged 65+ who have fallen in the previous year. It directly affects Medicare beneficiaries with recent falls and healthcare providers delivering these services under Medicare. The key mechanism expands existing Medicare benefits to include these specific fall prevention services, effective January 1, 2025. Additionally, it mandates annual reports starting in 2026 tracking falls data for seniors over 65 who received fall-related treatment.

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.

Maddy summaryThis bill (HR 7397) would define "essential health system" in federal law to specifically include certain hospitals serving high numbers of low-income patients. It targets non-Federal, non-profit hospitals that meet one of three criteria: having Medicaid disproportionate share status, serving at least 35% low-income Medicare patients, or receiving significant uncompensated care payments under Medicare. The definition applies to hospitals already designated under existing Medicaid and Medicare programs. This is a technical clarification to standardize how these hospitals are identified in federal statutes.

Maddy summaryThis bill requires Medicare to provide clear outreach and education so Medicare beneficiaries (enrolled in Part A, Part B, or Medicare Advantage plans) can authorize family caregivers to access their health information via 1-800-MEDICARE. It mandates the inclusion of a specific authorization form (CMS-10106) in Medicare notices and on Medicare.gov, along with training for call center staff. The Secretary must also share best practices to prevent fraud related to caregiver access and make materials available in non-English languages. It directly affects beneficiaries, their family caregivers, healthcare providers, and Medicare call center operators.

Maddy summaryThis bill expands eligibility for certain tax-advantaged health accounts to cover medical expenses for parents. It amends the tax code to allow individuals to use funds from Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs) for qualified medical care of their parents or their spouse's parents - previously limited to immediate family members. The changes apply to expenses incurred after December 31, 2023, directly benefiting adult caregivers (like children supporting elderly parents) who use these accounts for parental healthcare costs. The bill makes no new funding commitments but adjusts existing account rules to reduce out-of-pocket costs for caregivers.

Maddy summaryThis bill, HR 6860, protects patients with end-stage kidney disease (ESRD) who require dialysis by preventing health insurance plans from discriminating against them. It amends Medicare rules to prohibit plans from treating dialysis coverage differently than other medical services based on a patient’s ESRD diagnosis, need for dialysis, or any other factor. The bill clarifies that plans can still choose which dialysis providers to include in their networks but cannot deny or limit coverage for dialysis services solely because of the patient’s condition. It ensures Medicare remains the secondary payer for these services as intended, without forcing plans to cover specific providers.

Maddy summaryHR 6790 establishes National Institutes of Health centers to advance research, early detection, and public awareness of rare kidney diseases, with a focus on rural and underserved communities. It mandates a federal study on genetic testing barriers, treatment patterns, and public awareness for rare kidney diseases affecting disproportionately impacted populations, including barriers to insurance coverage and access to specialists. The bill also funds nephrology training programs to increase specialists serving these communities and requires experiments to delay or prevent the need for dialysis and transplants. Total funding of $7 million is authorized for fiscal years 2024-2028 to support these research, education, and early intervention efforts.

Maddy summaryThis bill updates Medicare's physician fee schedule to better align with current healthcare costs and support providers. It extends a key deadline for geographic payment adjustments from 2024 to 2025, increases the rate for payment adjustments from 1.25% to 3%, and extends incentive payments for doctors in alternative payment models (APMs) through 2026. For 2026, it imposes payment reductions (34% for 4-6 years in APMs, 67% for 7+ years) but allows exceptions if providers increased their financial risk compared to 2025. The bill also raises Medicare's budget neutrality threshold to $53 million in 2025 and requires regular updates to cost data (like staff wages and equipment prices) every five years. These changes directly affect Medicare-participating physicians, especially those in APMs, by altering payment calculations and incentives.

Maddy summaryHR 6407, the Medical Nutrition Therapy Act of 2023, expands Medicare coverage to include medical nutrition therapy for more chronic conditions beyond current limits. It directly affects Medicare beneficiaries with conditions like obesity, hypertension, dyslipidemia, eating disorders, and others not previously covered under Part B. The bill amends Medicare rules to allow coverage for prevention, management, or treatment of these conditions by a wider range of providers, including registered dietitians and clinical psychologists. This change would make medically necessary nutrition services available for conditions listed in the bill, such as diabetes, cardiovascular disease, and HIV, as determined by the Secretary.