Rep. Chellie Pingree

Maddy summaryThis bill expands Medicare coverage for cardiac and pulmonary rehabilitation programs by updating who can prescribe these services. It allows physician assistants, nurse practitioners, and clinical nurse specialists (in addition to physicians) to authorize these programs under Medicare, broadening access for patients. The changes apply to services starting January 1, 2024, and directly affect Medicare beneficiaries needing cardiac or lung rehabilitation care. The policy simplifies provider eligibility without creating new funding or altering program structure.

Maddy summaryThis bill establishes minimum nurse-to-patient ratios for registered nurses in hospital units (such as 1:1 in trauma units, 2:1 in critical care units, and 3:1 in emergency rooms), requiring hospitals to develop and maintain staffing plans that meet these standards. It mandates transparency in documenting staffing levels, ensures hospitals verify nurses' competence for specific units, and enforces compliance through Medicare and Medicaid programs with penalties for violations. The bill protects nurses who refuse unsafe assignments due to staffing concerns and includes initiatives to improve nurse retention and address staffing shortages. It directly affects hospitals, nurses, and patients by aiming to improve patient safety and care quality through standardized staffing requirements. The bill applies to all hospitals, with extended implementation timelines for rural facilities.

Maddy summaryThe PROTECT 340B Act of 2023 prohibits pharmacy benefit managers (PBMs), health insurance plans, and health insurance issuers from discriminating against healthcare providers participating in the 340B drug pricing program. It specifically bans these entities from paying less for 340B drugs than they would for similar drugs dispensed by non-340B providers, imposing special requirements on 340B providers, or requiring identification of 340B drugs in billing. The bill establishes civil penalties of up to $5,000 per violation per day for PBMs that violate these protections and requires the Health Resources and Services Administration to create implementing regulations. It directly affects safety-net hospitals, clinics, and health centers that serve low-income patients, particularly those in rural areas, by protecting their ability to use 340B drug discounts to provide affordable care.

Maddy summaryThis bill would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.

Maddy summaryThis bill requires Medicare, Medicaid, and CHIP to cover advanced genetic cancer testing (like DNA/RNA sequencing and their interpretation) for patients diagnosed with cancer. It defines covered tests as next-generation sequencing performed by clinical labs and limits coverage to once per diagnosis, recurrence, or treatment monitoring. Medicare will pay 80% of the test cost (or 100% if billed under assignment), while Medicaid and CHIP must include these tests in mandatory coverage starting January 1, 2025. The bill directly affects cancer patients enrolled in these federal health programs by ensuring access to specific genetic testing without excessive out-of-pocket costs.

Maddy summaryHR 1754, the Healthcare Ownership Transparency Act, requires Medicare-participating healthcare providers (called "covered firms") to disclose detailed financial and ownership information to the Centers for Medicare & Medicaid Services (CMS). Specifically, it mandates that firms owned by private equity funds submit 28 types of data - including debt structure, fees paid to private equity, political spending, vendor relationships, and leadership details - for each of the previous 10 years. Non-private equity-owned firms must also report core financial metrics like debt levels and political spending. The bill creates a new task force to study healthcare consolidation and private equity’s impact, and requires the GAO to analyze disclosed data to assess effects on costs, staffing, and quality. This aims to increase transparency around ownership structures influencing healthcare costs and operations.

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 summaryHR 1666 extends deadlines for ambulance service reimbursement rules under Medicare. It amends Section 1834(l) of the Social Security Act by changing dates from 2025 to 2028 in two specific provisions: paragraph (12)(A) and paragraph (13)(A). This delay gives ambulance providers additional time to adjust to existing Medicare payment rules. The bill directly affects Medicare-certified ambulance services and the patients relying on ground ambulance care covered by Medicare.

Maddy summaryThis bill increases Medicare reimbursement for clinical social workers from 75% to 85% of the payment rate for psychologists under Part B. It also removes an exclusion that previously prevented skilled nursing facilities from billing Medicare for social worker services provided to residents. The bill expands covered services to include specific mental health assessments and interventions identified by HCPCS codes (like 96156, 96158-96161, etc.) for Medicare beneficiaries. These changes take effect for services provided on or after January 1, 2024, directly affecting Medicare patients and clinical social workers.

Maddy summaryThe Prevent Interruptions in Physical Therapy Act of 2023 amends Medicare rules to allow physical therapists to use temporary replacement providers (locum tenens) for outpatient physical therapy services, aligning with existing provisions for physicians. This directly affects Medicare beneficiaries receiving physical therapy and physical therapy practices needing temporary staffing solutions during provider shortages. The bill updates the Social Security Act to extend the current physician locum tenens rule to physical therapists, ensuring continuity of care without requiring separate approval for temporary coverage. It applies to services furnished after the bill's enactment date.