Rep. Michelle Fischbach

Maddy summaryHR 8244 would require skilled nursing facilities participating in Medicare or Medicaid to meet stricter approval standards for training programs if they've received significant fines for quality-of-care issues. Specifically, facilities must not have been assessed a fine of at least $12,924 for deficiencies related to resident care quality within the past year. The bill amends existing law to update the criteria for temporarily barring such facilities from offering nursing aide training programs. This directly affects nursing homes that have faced enforcement actions under Medicare or Medicaid quality standards.

Maddy summaryThis bill updates federal law to ensure tribal child support enforcement agencies have the same access to tax information as state agencies. It amends the Social Security Act and Internal Revenue Code to explicitly include tribal organizations receiving federal grants under Section 455(f) in provisions allowing the use of tax refund data to collect overdue child support payments. Tribal agencies will now be treated equally with state agencies for accessing tax information and receiving reimbursement for enforcement reports. This change directly affects Native American tribes operating child support programs and the parents and children they serve, enabling more effective collection of overdue support.

Maddy summaryThis bill creates a 4-year transitional coverage period for Medicare to automatically cover "breakthrough medical devices" - new FDA-prioritized devices approved after March 2021 - as "reasonable and necessary" for treatment. During this period, these devices qualify for additional payments under Medicare's hospital and outpatient payment systems without requiring separate approval. After the 4-year period, Medicare must develop regular coverage based on additional data, with automatic coverage for all approved uses if no action is taken within two years. The bill requires Medicare to assign unique codes for these devices within three months of FDA approval and to update payment systems regularly. It also includes special provisions for "specified breakthrough devices" that lack existing Medicare benefit categories, requiring reports on their impact and cost to Congress.

Maddy summaryThis bill, HR 1097 (Everett Alvarez, Jr. Congressional Gold Medal Act of 2023), authorizes the award of a Congressional Gold Medal to Everett Alvarez, Jr., in recognition of his service as a U.S. Navy pilot and Vietnam War prisoner of war. It directly honors Alvarez, who was the first U.S. pilot shot down in the Vietnam War, spent over 8.5 years in captivity, and later served in the Peace Corps and Veterans Administration. The bill’s key mechanism is directing the U.S. Mint to strike a gold medal bearing his name and image, with bronze duplicates available for sale to cover costs. It does not create new policies or affect any group beyond the honoree.

Maddy summaryHR 8784, the FREE Act, requires federal agencies to replace slow, discretionary permitting systems with a streamlined "permit by rule" process. Applicants would certify compliance with written requirements, and permits would automatically be approved within 30 days unless the agency proves non-compliance. Agencies must first report on all current permits and identify which could switch to this system, with a deadline of 240 days after enactment. This directly affects federal agencies managing permits and applicants seeking permits, aiming to reduce delays while maintaining enforcement for violations through audits and appeals.

Maddy summaryHR 7513, the Protecting America’s Seniors’ Access to Care Act, prohibits the Department of Health and Human Services from implementing or enforcing a proposed rule that would have set minimum staffing requirements for nursing homes and other long-term care facilities receiving Medicare or Medicaid funding. The bill specifically blocks the September 2023 proposed rule (88 Fed. Reg. 61352-61429) and any substantially similar rule. This directly affects long-term care facilities that rely on federal healthcare program payments. The key mechanism is a clear statutory prohibition preventing the rule from taking effect, without altering existing staffing standards or requirements.

Maddy summaryHR 3269, the Law Enforcement Innovate to De-Escalate Act, exempts specific less-than-lethal projectile devices from federal firearm taxes and National Firearms Act restrictions. The bill defines these devices as those firing projectiles at under 500 feet per second and designed not to cause death or serious injury. This directly affects law enforcement agencies using such devices and manufacturers producing them, by removing tax burdens and registration requirements. The key change is creating a clear legal exemption for these devices under federal law, streamlining their use for de-escalation purposes.

Maddy summaryThis bill expands Medicare reimbursement for hospitals operating nursing and allied health education programs. It allows hospitals to include more costs - like direct expenses, allocated costs from related entities (e.g., parent companies or shared-board organizations), and training-related costs - in their Medicare cost reports, starting after enactment. Hospitals with state-licensed or nationally accredited programs will directly benefit by receiving full reimbursement for these costs, and the bill requires refunds for Medicare overpayments made in the prior six years. This policy change aims to strengthen healthcare workforce training by improving financial support for hospital-based education programs.

Maddy summaryThe University Accountability Act imposes penalties on tax-exempt universities found in federal court to have violated Title VI of the Civil Rights Act of 1964, requiring them to pay $100,000 or 5% of their administrative compensation per violation. It mandates the IRS to review the tax-exempt status of institutions with more than two such violations and requires these institutions to report civil rights violations on their tax returns. If a violation determination is overturned, the penalty must be refunded. The bill applies to most public and private universities that are tax-exempt under federal law, directly affecting their financial obligations and reporting requirements.

Maddy summaryThe MOMS Act establishes a federal resource website called pregnancy.gov that will help pregnant and postpartum women find local services through a ZIP code-based search system. It creates grant programs to support nonprofit organizations providing services like medical care, housing assistance, and parenting support to pregnant women, while prohibiting organizations that provide or support abortion from receiving these funds. The bill also amends child support laws to allow enforcement of child support obligations for unborn children, beginning from the month of conception with the mother's consent. These provisions aim to improve access to prenatal and postnatal resources while maintaining a focus on supporting women and their families.