Rep. Donald G. Davis

Maddy summaryThis bill amends Medicare's Shared Savings Program rules to change how Accountable Care Organizations (ACOs) count primary care services toward their performance metrics. Starting in 2025, ACOs will include Medicare-covered primary care services provided by their participating doctors and providers in their quality and cost calculations. The change specifically applies to performance years beginning January 1, 2025, and affects ACOs participating in Medicare's Shared Savings Program. This adjustment modifies the technical criteria for ACOs to demonstrate value, directly impacting how they report and earn shared savings.

Maddy summaryThis bill requires Medicare to cover falls risk assessments and fall prevention services during annual wellness visits and initial preventive physical exams for seniors aged 65+ who have fallen in the previous year. It directly affects Medicare beneficiaries with recent falls and healthcare providers delivering these services under Medicare. The key mechanism expands existing Medicare benefits to include these specific fall prevention services, effective January 1, 2025. Additionally, it mandates annual reports starting in 2026 tracking falls data for seniors over 65 who received fall-related treatment.

Maddy summaryThis bill amends Medicare rules to expand eligibility for rural emergency hospitals. It changes the timeframe during which hospitals can qualify for this specific Medicare reimbursement status, allowing facilities to meet eligibility requirements at any point from January 1, 2015, onward. The change directly affects rural hospitals seeking to become designated Medicare rural emergency hospitals to receive appropriate federal funding. This is a technical adjustment to Medicare eligibility rules, not a new funding program.

Maddy summaryThe MATCH IT Act of 2024 establishes national standards to improve patient matching accuracy in electronic health records. It requires the Secretary to create a uniform definition for measuring patient match rates (accounting for duplicate/overlaid records) and develop a minimum data set to support 99.9% matching accuracy by healthcare systems. The bill mandates incorporating this data set into health IT certification requirements and Medicare interoperability programs within 18-24 months. It also creates a voluntary Medicare bonus for providers meeting 90% patient match rates, with anonymous reporting of accuracy data. This directly affects healthcare providers, health IT vendors, and Medicare participants by requiring standardized matching protocols to reduce medical errors and costs linked to misidentification.

Maddy summaryThis bill (HR 7397) would define "essential health system" in federal law to specifically include certain hospitals serving high numbers of low-income patients. It targets non-Federal, non-profit hospitals that meet one of three criteria: having Medicaid disproportionate share status, serving at least 35% low-income Medicare patients, or receiving significant uncompensated care payments under Medicare. The definition applies to hospitals already designated under existing Medicaid and Medicare programs. This is a technical clarification to standardize how these hospitals are identified in federal statutes.

Maddy summaryThe Protecting the Families of Our Fallen Patriots Act changes Social Security rules to help military families. It exempts certain survivor benefits from the income test that normally reduces Social Security payments for people who earn money while receiving benefits. Specifically, surviving spouses and surviving divorced parents who receive benefits based on a service member's earnings (if the service member died while on active duty) will no longer see those benefits reduced due to their income. This change applies to benefits paid starting from the bill's enactment date.

Maddy summaryThe REDUCE Act simplifies administrative requirements for physical and occupational therapists. It eliminates redundant paperwork by allowing therapists to submit a care plan to the ordering physician within 30 days after an initial evaluation, instead of requiring separate certifications. Physicians can then amend the care plan within 10 business days. This directly affects therapists, physicians, and Medicare patients receiving outpatient therapy services, reducing bureaucratic delays without requiring new physician orders. The bill aims to streamline care coordination under Medicare Part B.

Maddy summaryThis bill clarifies that Medicare must cover fully implanted active middle ear hearing devices as prosthetics, not as hearing aids. It requires the Centers for Medicare & Medicaid Services (CMS) to update its rules within 60 days of the bill's enactment to remove these devices from Medicare's hearing aid coverage exclusion. This directly affects Medicare beneficiaries who rely on these specific implanted devices for hearing. The change means these devices will now be covered under Medicare's prosthetic benefits, not excluded under hearing aid rules, without altering existing coverage for other hearing aids.

Maddy summaryThis bill changes the negotiation period for small-molecule drugs under the federal Drug Price Negotiation Program from 7 years to 11 years, matching the existing 11-year period for biologic drugs. It directly affects drug manufacturers participating in the program by extending the timeframe for price negotiations with the government. The amendment applies to all small-molecule drugs covered under the program, creating a uniform negotiation timeline for both drug types. The change takes effect as if included in the Inflation Reduction Act of 2022.

Maddy summaryHR 7142 (Alternatives to PAIN Act) requires Medicare Part D plans to cover non-opioid pain management drugs with no deductible and at the lowest copay level starting in 2025. It defines "qualifying non-opioid drugs" as FDA-approved medications that don’t act on opioid receptors (like certain NSAIDs or nerve pain treatments), excluding opioids and schedule I-III drugs. The bill prohibits Medicare plans from forcing patients to try opioids first (step therapy) or requiring prior approval for these non-opioid options. It directly affects Medicare beneficiaries needing pain management, especially those seeking alternatives to opioids for post-surgical or acute pain. The policy change aims to improve access to non-addictive pain treatments while preserving doctors' authority to prescribe medically appropriate care.