Rep. Larry Bucshon

Maddy summaryThis bill expands financial support for living organ donors by amending the Public Health Service Act. It prohibits reimbursement programs from considering the recipient's income when covering donors' expenses and allows donors with household income up to 700% of the poverty line to qualify for reimbursement. Reimbursement is capped at $10,000 for fiscal year 2026 (adjusted annually for inflation), covering costs like travel or lost wages. The bill also requires annual reports tracking program participation, expenses, and impacts on Medicare savings, with funding authorized through 2035.

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 summaryHR 9805, the Access to Claims Data Act, allows qualified clinical data registries and clinician-led registries to access Medicare claims data (and potentially Medicaid/CHIP data if approved) for research and quality improvement. The bill requires the HHS Secretary to establish a process by January 2025 for these registries to request de-identified claims data to link with clinical outcomes, assess provider quality, and publish research findings. Access is provided at cost-recovery fees, deposited into a federal account, and the registries are exempt from needing "qualified entity" status under current law. This law directly affects healthcare data organizations aiming to improve patient care through research using existing claims information.

Maddy summaryHR 9778, the PAVE Act, requires Medicare to include penicillin allergy verification during routine preventive exams and annual wellness visits for seniors aged 65 and older. The bill mandates identifying patients with self-reported penicillin allergies, assessing whether their history indicates a true allergy, explaining the health risks of a false label, and referring to specialists when needed. This applies to Medicare-covered visits starting January 1, 2025, directly affecting seniors with penicillin allergy labels in their medical records. The goal is to correct false allergies - supported by evidence showing over 90% of such labels are inaccurate - improving treatment options and reducing unnecessary healthcare costs.

Maddy summaryThis bill establishes a process for Medicare to set payment rates for certain pediatric medical devices used in children's care. Manufacturers of qualifying pediatric technologies (devices approved by the FDA, covered under Medicare, and designed specifically for children or used predominantly in pediatric procedures) can request the Secretary to create national payment rates under the physician fee schedule. The Secretary must then set these rates using available data like claims or pricing information, with specific deadlines for processing requests (by May 1 for same-year implementation). This affects Medicare payments for these devices but does not change coverage requirements or guarantee payment for new technologies.

Maddy summaryThis bill creates an exemption from certain physician self-referral rules for specific rural hospitals. It defines a "covered rural hospital" as one located more than 35 miles (or 15 miles in mountainous terrain) from another hospital or critical access hospital, primarily affecting rural facilities in remote areas. The bill also removes restrictions preventing physician-owned hospitals from expanding their services. These changes directly impact rural hospitals meeting the new distance criteria and physicians owning hospitals in those areas, while leaving most existing Medicare self-referral rules unchanged.

Maddy summaryThe PROVE IT Act of 2024 directs the U.S. Energy Secretary to study and publicly report on the greenhouse gas emissions intensity of key U.S. manufactured products (like steel, aluminum, lithium batteries, and critical minerals) compared to those produced in "covered countries" (including the EU, China, and major trading partners). It requires a transparent methodology for calculating emissions data, identifies gaps in existing data, and establishes a public online database showing U.S. emissions advantages for these products. The bill also mandates an annual report on foreign countries using forced labor or human rights abuses in the production of critical minerals or rare earths. Importantly, it clarifies the study does not create new taxes, fees, or mandatory reporting requirements.

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 340B ACCESS Act amends the 340B Drug Pricing Program to strengthen oversight and ensure discounts reach vulnerable populations. It establishes new patient affordability requirements that limit out-of-pocket costs for eligible patients (e.g., $0 for those below the Federal poverty line, up to $35 for those between poverty line and 200% of poverty). The bill adds requirements for hospital child sites, contract pharmacies, and covered entities to prevent duplicate discounts, improve transparency, and creates a claims data clearinghouse to monitor program compliance. It imposes civil penalties for noncompliance, including fines up to $13,946 per violation for contract pharmacies that violate program requirements.

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.