Rep. Andy Harris

Maddy summaryThe Preserving Seniors’ Access to Physicians Act of 2023 increases the Medicare payment adjustment rate for physicians from 1.25% to 4.62%, directly affecting doctors who treat Medicare patients (primarily seniors). It also reduces the funding for the Medicaid improvement fund from $5,796,117,810 to $3,973,117,810. These changes impact Medicare providers and Medicaid programs, with the Medicare adjustment aimed at supporting physicians adjusting to payment changes. The bill does not specify how the Medicaid funding reduction relates to its stated goal of preserving seniors' access to physicians.

Maddy summaryThis bill updates Medicare physician payment rules to improve stability and accuracy. It raises the budget neutrality threshold from $20 million (pre-2025) to $53 million in 2025, with annual indexing after 2026, to prevent excessive payment adjustments. The bill requires the Medicare program to correct budget neutrality payments based on actual service utilization data (not estimates) starting in 2025, and mandates updating direct cost inputs (like staff wages and equipment prices) every 5 years. It also caps annual changes to the physician payment conversion factor at 2.5% to limit sudden payment shifts, directly affecting Medicare physicians and healthcare providers receiving these payments.

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 creates an exemption for Medicare Advantage plan physicians who had at least 90% of their prior authorization requests approved for specific services in the previous year. These doctors would be exempt from needing pre-approval for those same services in subsequent plan years, reducing administrative delays for patients. The exemption continues until revoked (based on updated approval rates) or the physician opts out. It also requires plans to allow providers to discuss treatment plans with a qualifying physician during the authorization process.

Maddy summaryThis bill creates a presumption that minerals from the Democratic Republic of Congo (DRC) containing cobalt and lithium, mined with child or forced labor, cannot be imported into the United States. It requires the U.S. government to develop an enforcement strategy to identify and block such imports, including monitoring supply chains and working with international partners. The bill mandates diplomatic efforts to address child and forced labor in the DRC's mining sector and establishes sanctions against foreign entities that facilitate or engage in such labor practices. The focus is on minerals critical for electric vehicles and electronics, which are heavily sourced from the DRC and processed in China, with specific attention to Chinese mining companies like China Molybdenum that dominate the DRC's cobalt sector.

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 repeals the tax on Social Security benefits for seniors, making those benefits fully tax-free. It directly affects seniors who receive Social Security benefits and are currently subject to income tax on a portion of those payments. The key provision removes Section 86 of the tax code that previously included benefits in gross income, while a separate funding mechanism appropriates money to Social Security trust funds to replace the lost revenue. The bill ensures Social Security trust funds remain fully funded without requiring new tax increases.

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 summaryHR 1399, the "Protect Children's Innocence Act," prohibits medical gender-affirming care for minors under 18 by making it a class C felony for providers to perform such care. The bill defines gender-affirming care broadly to include surgical procedures, hormone treatments, and certain cosmetic procedures, with exceptions for medical conditions like reproductive cancers or intersex conditions. It prohibits federal funding for gender-affirming care through programs like Medicaid, Medicare, and the Affordable Care Act, and bans such care in federal health facilities. The bill also prevents institutions of higher education from teaching gender-affirming care and adds immigration consequences for individuals who provide such care to minors.

Maddy summaryThis bill repeals specific provisions from the Affordable Care Act and its 2010 amendment that restricted certain physician referrals to hospitals under Medicare. It directly affects hospitals and physicians who previously faced limitations on referring Medicare patients to facilities they owned or had financial ties with. The key mechanism restores the original rules that allowed such referrals without the prior restrictions, effectively undoing the 2010 changes. This is a procedural change to existing law, not a new policy.