Maddy summaryThis bill simplifies participation in Medicare's Accountable Care Organization (ACO) program by removing distinctions between small and large ACOs and eliminating the requirement for new ACOs to assume financial risk for three years before joining shared savings models. It creates a new "100% shared savings" option where ACOs keep all savings from cost reductions but bear full financial responsibility for losses. The bill also mandates clearer, transparent benchmark calculations for ACO performance, establishes appeal processes for disputed benchmarks, and requires technical assistance for rural and underserved providers. These changes directly affect Medicare ACOs, particularly smaller or newer organizations in rural or safety-net settings, aiming to make value-based care participation more accessible.
Rep. Donald G. Davis
Sponsored bills
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 summaryThe HOPE for Haitian Prosperity Act extends duty-free access for Haitian goods to the U.S. market until 2035, with specific extensions for apparel and other exports. It requires Haitian producers to meet labor standards on minimum wages, working hours, and safe conditions to maintain this trade benefit. The bill also creates a new U.S. technical assistance program to help Haiti diversify exports, focusing on agriculture, apparel, and services, while requiring collaboration with Haitian government, businesses, and labor groups. Annual reports to Congress will track progress on these efforts.
Maddy summaryThis bill prevents Medicare from imposing stricter supervision requirements for outpatient physical therapy and occupational therapy than those established by state law, requiring Medicare to follow existing state regulations instead. It takes effect January 1, 2024, directly affecting Medicare-covered therapy services in all states. Additionally, it mandates a Government Accountability Office study by December 2024 to analyze how Medicare’s 15% payment differential for therapy assistants impacts access to care in rural and underserved areas. The study will examine this payment policy across all Medicare Part B settings.
Maddy summaryThe 9-8-8 Implementation Act of 2023 establishes a national mental health crisis response system centered around the 9-8-8 suicide prevention hotline. It provides $441 million for call center technology, staffing, and operations, and requires Medicare, Medicaid, and private health plans to cover crisis response services including mobile crisis teams and crisis stabilization facilities. The bill also mandates a national suicide prevention media campaign and creates protocols for 9-1-1 dispatchers to better respond to mental health crises. These provisions aim to improve access to mental health crisis care across the United States.
Maddy summaryThe Physical Therapist Workforce and Patient Access Act of 2023 expands the National Health Service Corps to include physical therapists in its loan repayment program and creates designated "physical therapy health professional target areas" for their assignment in underserved communities. It also amends Medicare to cover physical therapy services provided by physical therapists at Rural Health Clinics and Federally Qualified Health Centers, effective January 1, 2025. This directly affects physical therapists by offering new career pathways in underserved areas and patients in those communities by increasing access to physical therapy services for conditions like pain management and rehabilitation. The bill does not alter existing eligibility requirements for physical therapists but formally integrates their services into key federal healthcare programs.
Maddy summaryHR 4638, the Integrating Social Workers Across Health Care Settings Act, amends Medicare rules to expand coverage for clinical social workers. It removes a current restriction limiting their services to "diagnosis and treatment of mental illnesses" and broadens the definition to include all clinical social work services and related supplies provided during the same service encounter. This change will take effect on December 1, 2024, allowing Medicare to cover social workers' support for a wider range of health conditions, such as chronic disease management and care coordination. It directly affects Medicare beneficiaries, clinical social workers, and healthcare providers who bill Medicare for these services.
Maddy summaryThe Social Security 2100 Act would significantly enhance Social Security benefits for millions of Americans by increasing monthly payments for retirees, disabled workers, widows/widowers, and children. Key provisions include raising the minimum benefit for long-term low earners, improving cost-of-living adjustments using a more accurate index, eliminating the 5-month waiting period for disability benefits, and extending child benefits to age 26. The bill also changes how Social Security taxes are calculated by applying them to income above $400,000 and establishes a unified Social Security Trust Fund to manage program finances. Most provisions would apply to benefits payable from 2025 through 2034, affecting all current and future Social Security beneficiaries.
Maddy summaryThis bill expands Medicare coverage to include home infusion treatment for people with Alpha-1 Antitrypsin Deficiency Disorder, a genetic condition causing lung and liver damage. It specifically covers "augmentation therapy" (a standard treatment using Alpha-1 Proteinase Inhibitor) when administered in a patient's home by qualified providers. Medicare will pay 80% of the cost for intravenous kits and up to 2 hours of nursing care during these home infusions, starting January 1, 2025. The change directly affects Medicare beneficiaries with this condition who require home-based treatment and their qualified home infusion providers.
Maddy summaryThis bill prohibits Medicare from paying for certain custom-fitted or custom-fabricated orthotic and prosthetic devices delivered via "drop shipment" (direct shipping without in-person training from a qualified provider). It directly affects Medicare beneficiaries who need these devices, ensuring they receive necessary in-person fitting and training. The bill also expands which healthcare professionals (including physical therapists, occupational therapists, orthotists, and prosthetists) can prescribe these devices and updates definitions to clarify terms like "orthoses" and "prostheses." Final regulations implementing these changes must be issued within one year of the bill's enactment.