Rep. Jill N. Tokuda

Maddy summaryThis bill adds Medicare coverage for "home resiliency services" to help vulnerable beneficiaries prepare for disasters. It covers medically necessary items like heat pumps for temperature-sensitive patients, solar batteries for medical equipment users (e.g., home ventilators), and energy-efficient cold storage for heat-sensitive medicines. Medicare will pay 100% of the cost for these services if the Secretary determines an individual is medically vulnerable during climate or manmade disasters, based on factors like chronic conditions, medical equipment reliance, and regional climate risks. It directly affects Medicare beneficiaries with chronic health needs who face heightened risks during extreme weather or infrastructure failures.

Maddy summaryThis bill, the Public Servants Protection and Fairness Act of 2023, amends Social Security to better protect public servants who work in jobs not covered by Social Security (such as certain government positions). It creates a new formula for calculating retirement benefits that combines both covered and noncovered earnings, ensuring public servants receive the higher of two benefit calculations. The bill also provides an additional $150 monthly payment for certain public servants whose benefits were previously reduced by the windfall elimination provision. It improves Social Security account statements to clearly show noncovered earnings and requires a study of how state retirement plans handle these benefits. These changes will apply to benefits starting in 2025.

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 CONNECT for Health Act of 2023 aims to expand access to telehealth services under Medicare by removing barriers that previously limited who could provide these services and where they could be delivered. The bill eliminates geographic restrictions on telehealth coverage, allows telehealth services to be provided from the patient's home and other clinically appropriate locations, and expands the types of healthcare providers who can offer telehealth services. It also improves the process for adding new telehealth services to Medicare coverage and includes provisions to ensure quality measurement includes telehealth services. This legislation directly affects Medicare beneficiaries seeking remote care and healthcare providers delivering telehealth services, with key provisions taking effect between 2024 and 2025.

Maddy summaryThe LIFT the BAR Act removes barriers preventing lawfully present noncitizens from accessing federal benefits like food assistance, Medicaid, and school meals. It repeals specific 1996 welfare law provisions that excluded noncitizens and updates terminology to replace "alien" with "noncitizen" throughout federal law. The bill expands eligibility to include noncitizens in categories such as Deferred Action for Childhood Arrivals (DACA) recipients, individuals with special immigrant juvenile status, and those with pending U-visa applications. This change ensures more noncitizens lawfully present in the U.S. can access essential services without being denied based on immigration status.

Maddy summaryThis bill amends Medicare rules to improve access to home infusion therapy, which delivers IV medications at home for conditions like chronic diseases. It adds pharmacy services (including drug preparation and compounding) to covered Medicare benefits and creates a payment rule: if a supplier isn't physically present during therapy, Medicare pays 50% of the full rate instead of denying payment. It also allows nurse practitioners and physician assistants to establish and review home infusion care plans, previously limited to physicians. These changes, effective January 2024, directly affect Medicare beneficiaries requiring home infusion therapy and providers delivering these services.

Maddy summaryThe Public Health Emergency Response Act (HR 4009) creates new paid leave requirements for employees during public health emergencies. It requires employers to provide up to 12 weeks of paid leave (capped at $511 per day) for employees needing to care for family members due to disruptions in childcare or school, or for employees who are ill with a covered infectious disease. The bill provides tax credits to employers who pay for this leave, covering 100% of qualifying wages for businesses with fewer than 500 employees. Self-employed individuals are also eligible for tax credits to cover equivalent leave costs. The law applies to public health emergencies declared by the Secretary of Health and Human Services on or after January 1, 2022.

Maddy summaryHR 3875, the Expanded Telehealth Access Act, expands Medicare coverage for telehealth services by adding new healthcare professionals to the list of providers eligible for payment. It specifically includes licensed audiologists, occupational therapists (and their assistants under supervision), physical therapists (and their assistants under supervision), and speech-language pathologists. The bill ensures these providers are paid the same rate for telehealth services as they would be for in-person care under Medicare. This change directly affects Medicare beneficiaries seeking remote therapy services and the new provider types who can now offer these services via telehealth.

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.

Maddy summaryThis bill simplifies regulations for rural health clinics (RHCs) by reducing administrative burdens. It allows RHCs to contract with physician assistants and nurse practitioners (instead of requiring direct employment), updates the definition of "rural" to exclude areas with 50,000+ residents, and removes outdated lab service requirements by requiring only "prompt access" to clinical labs. These changes directly affect RHCs, enabling them to more flexibly staff and operate while complying with state practice laws. The amendments take effect January 1, 2024, applying to services provided on or after that date.