Rep. Dean Phillips

Maddy summaryHR 5744, the Energy Innovation and Carbon Dividend Act of 2023, would impose a carbon fee on fossil fuels (crude oil, coal, and natural gas) based on their greenhouse gas emissions, starting at $15 per metric ton of CO2 equivalent in 2023 and increasing by $10 annually. The revenue from this fee would be distributed directly to American citizens as monthly "carbon dividends" through a new trust fund, with adults receiving full payments and children under 19 receiving half payments. The bill also establishes a border fee adjustment on imported carbon-intensive products to prevent companies from moving operations to countries with weaker environmental regulations. It sets specific emissions reduction targets: 8% annual reductions from 2025-2030 and 2.5% annual reductions from 2031-2050 relative to 2005 levels. The carbon fee would be phased out once emissions drop to 10% of 2005 levels and monthly dividends fall below $20 for three consecutive years.

Maddy summaryThis bill provides continuing appropriations for federal government operations through January 11, 2024, ensuring funding for ongoing programs and activities. It includes $16 billion for disaster relief and over $21 billion in supplemental funding for Ukraine assistance, covering military aid, economic support, and humanitarian programs. The bill also extends funding for community health centers, Federal Aviation Administration programs, and the Temporary Assistance for Needy Families program through the same date. These funding measures maintain government operations and support critical domestic and international programs during the fiscal year.

Maddy summaryHR 5663, the ALS Better Care Act, creates a new Medicare payment system to improve reimbursement for specialized care services provided to ALS patients. It establishes a $800 per visit payment rate starting in 2025 for qualified ALS care facilities, with annual increases based on market basket adjustments. The bill requires the Comptroller General to report on appropriate payment amounts and ensures this new payment is in addition to, not replacing, existing Medicare payments for ALS-related services. This aims to reduce wait times, support facilities in rural areas through telehealth access, and address funding challenges for ALS clinical trials.

Maddy summaryThe MORE Act (HR 5601) would federally decriminalize cannabis by removing it from the Schedule I list of controlled substances under the Controlled Substances Act. It requires federal courts to expunge non-violent cannabis convictions and associated arrests, with a focus on addressing racial disparities in cannabis enforcement. The bill creates an Opportunity Trust Fund that would allocate 50% of funds to criminal justice programs, 20% to small business assistance for minority cannabis entrepreneurs, and 20% to community reinvestment grants for individuals impacted by the War on Drugs. It also prohibits federal agencies from denying benefits or security clearances based on cannabis use or past cannabis convictions, and establishes a Cannabis Justice Office to administer these programs.

Maddy summaryThe DRA of 2023 adjusts Medicare payment rates for specific durable medical equipment (DME) items that were part of the 2021 competitive bidding program but for which no supplier contracts were finalized. It directly affects DME suppliers and Medicare beneficiaries by establishing a new 2024 payment formula: 90% of the adjusted payment amount plus 10% of the unadjusted fee schedule for eligible items. The bill also extends a temporary transition rule for non-rural areas through December 31, 2024, while delaying a regulatory change until 2025. These provisions aim to stabilize payments for DME items that did not transition to standard pricing under prior rules.

Maddy summaryThe HANDS Act requires Medicare, Medicaid, and TRICARE to cover naloxone (an opioid overdose reversal drug) with no out-of-pocket costs when distributed by hospitals to patients identified as at-risk for overdose. It applies to individuals receiving care in hospital emergency departments, inpatient settings, or ambulatory surgical centers, specifically at the time of discharge or when leaving the facility. The bill mandates that providers must determine a patient's overdose risk before distributing naloxone, along with administration instructions. This policy change eliminates cost-sharing barriers for this specific naloxone distribution method, aiming to increase access for vulnerable patients.

Maddy summaryThis bill clarifies that Medicare must cover external infusion pumps and associated non-self-administrable drugs as durable medical equipment (DME) when specific criteria are met. It directly affects Medicare beneficiaries requiring home infusion therapy for drugs that must be prepared just before use, administered by a healthcare professional, or labeled for external pump use at least monthly. Key provisions require the drug's FDA labeling to specify external pump administration, safe home delivery by qualified suppliers, and preparation/administration requirements. The bill mandates Medicare coverage under existing rules (LCD L33794) for qualifying treatments, effective upon enactment or FDA approval, whichever is later.

Maddy summaryHR 5376, the Share the Savings with Seniors Act, changes Medicare Part D drug cost-sharing rules for specific chronic medications starting in 2025. It limits what seniors pay for certain chronic care drugs (like anticoagulants, blood glucose regulators, and respiratory medications) by capping pre-deductible costs at the drug's net price and requiring coinsurance after the deductible to be based on that net price. This directly affects Medicare Part D beneficiaries taking these defined chronic medications. The bill aims to reduce out-of-pocket costs by tying payment limits to the negotiated drug price rather than list price or other benchmarks.

Maddy summaryHR 5371, the Choices for Increased Mobility Act of 2023, updates Medicare payment rules for manual wheelchairs. It clarifies that Medicare Part B will not cover the extra cost of titanium or carbon fiber materials in a wheelchair's base, effective January 1, 2023. This specifically affects Medicare beneficiaries who use manual wheelchairs with these materials, as payments will now be calculated without including those component costs. The bill directly changes how Medicare reimburses providers for such wheelchairs by excluding these materials from the standard payment amount. This is a technical adjustment to Medicare's fee schedule, not a new benefit or eligibility change.

Maddy summaryThe Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.