Rep. Richard McCormick

Maddy summaryHR 5213 requires Medicare Advantage plans, Part D drug plans, and Medicare Administrative Contractors to base prior authorization decisions on evidence-based medical necessity standards, not arbitrary rules. It mandates input from practicing physicians when creating coverage rules, requires clear public posting of all preauthorization requirements on websites, and demands that coverage denials be reviewed by licensed physicians in the relevant specialty. This affects Medicare beneficiaries (primarily seniors and people with disabilities) by reducing arbitrary coverage denials for necessary care, while directly impacting healthcare providers and Medicare plans through new transparency and review requirements. The bill aims to streamline access to covered services by making coverage decisions more consistent, transparent, and clinically grounded.

Maddy summaryThis bill changes how the President can adjust imports for national security reasons. It requires Congress to approve such actions within 60 days through a joint resolution, rather than the President acting unilaterally. The bill redefines "covered articles" as items related to military equipment, energy resources, or critical infrastructure, and shifts investigations from the Commerce Department to the Defense Department. It also creates an exclusion process for certain imports and mandates reports on the economic effects of import adjustments. These changes increase congressional oversight of trade actions with national security implications.

Maddy summaryHR 5107, the Pandemic Unemployment Fraud Recoupment Act, extends the statute of limitations for enforcing fraud related to pandemic unemployment benefits from 3 years to 10 years across multiple programs, including Pandemic Unemployment Assistance, Federal Pandemic Unemployment Compensation, and Lost Wages Assistance. It requires states to recover overpayments from individuals who knowingly received benefits they weren’t entitled to, through deductions from future unemployment benefits, while maintaining existing due process protections like hearings before repayment. States may waive repayment if the overpayment wasn’t the individual’s fault or if repayment would be unfair. The bill applies directly to individuals who received pandemic-era unemployment benefits through fraudulent means, ensuring states have a longer timeframe to address these cases under established fraud procedures.

Maddy summaryHR 3611, the Kazakhstan Permanent Normal Trade Relations Act of 2023, makes Kazakhstan's existing "normal trade relations" (NTR) status permanent by removing the need for annual U.S. presidential reviews under the Trade Act of 1974. This bill directly affects U.S. trade policy with Kazakhstan, ending the requirement for the President to annually determine whether Kazakhstan meets emigration freedom standards (which it has satisfied since 1997). The key provision allows the President to formally extend permanent NTR treatment to Kazakhstan's products, eliminating the current annual review process. Once enacted, Kazakhstan would automatically receive the same most-favored-nation tariff rates as other NTR countries, streamlining trade without further congressional action.

Maddy summaryHR 3561, the PATIENT Act of 2023, requires hospitals, health insurance plans, and pharmacy benefit managers to publicly disclose detailed pricing information for healthcare services and drugs. Hospitals must publish standard charges for 300+ shoppable services, including gross charges, payer-specific negotiated rates, and discounted cash prices, with updates required annually. Health plans must provide real-time information on in-network rates, cost sharing, deductibles, and prior authorization requirements for covered services. The bill establishes enforcement mechanisms, including civil monetary penalties for non-compliance, with fines ranging from $300 per day for small hospitals to $5 million for large hospitals that fail to comply with the transparency requirements.

Maddy summaryThis bill prohibits federal funding for gender transition procedures - including hormone therapy, puberty blockers, and surgeries like genital reassignment - across all federal programs and health plans. It exempts procedures for medical conditions (such as disorders of sex development) and treatment of complications arising from such procedures. The bill also blocks Affordable Care Act premium tax credits and cost-sharing reductions for health plans covering these services, though individuals may purchase separate non-federal-funded coverage. State and private insurers can still offer such coverage using their own funds, but federal subsidies cannot be applied to it.

Maddy summaryThis bill regulates pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans. It prohibits PBMs from earning income based on drug prices or rebates (requiring flat fees instead), mandates equal reimbursement for all network pharmacies, and requires PBMs to report how much of drug rebates they pass through to Medicare plans. The law also mandates annual compliance certifications and requires the government to publish aggregated transparency data (without revealing specific plan details) starting in 2024. These changes directly affect Medicare Part D plans and the seniors who rely on them for prescription drug coverage.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

Maddy summaryThis bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.

Maddy summaryThe Emergency Care Improvement Act would permanently allow freestanding emergency centers (FECs) to receive Medicare and Medicaid reimbursement for emergency services. FECs are independently licensed facilities operating 24/7 with on-site physicians, providing emergency care equivalent to hospital-based emergency rooms. The bill sets payment rates for FECs equal to hospital outpatient department rates for higher-level emergency services, based on existing Medicare payment structures. This change would apply to over 110 FECs, mostly in Texas, which previously operated under a temporary pandemic waiver and demonstrated 21.8% cost savings to Medicare for similar care.