Rep. Donald G. Davis

Maddy summaryThis bill modifies Medicare's rules for clinical laboratory testing to reduce administrative burdens. It requires the use of statistically valid sampling (instead of full reporting) for "widely available" tests - defined as tests costing under $1,000 per test with over 100 labs performing them - to determine payment rates starting in 2026. The bill also delays reporting deadlines until 2027, updates how labs are defined for payment purposes, and adds annual payment increase caps (2.5% for common tests in 2024-2025, rising to 5% by 2028). These changes directly affect Medicare-participating labs, particularly independent and hospital-based labs conducting common tests.

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 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.

Maddy summaryThe HELLPP Act (HR 1634) amends Medicaid to recognize doctors of podiatric medicine (podiatrists) as physicians, enabling them to be reimbursed for services under Medicaid starting January 1, 2024. It also clarifies Medicare’s documentation requirements for therapeutic shoes for people with diabetes, mandating specific written certifications from a managing physician and a podiatrist to confirm medical necessity. These changes directly affect patients with foot conditions, especially those with diabetes, by improving access to podiatrist-provided care and coverage for therapeutic shoes. The bill includes a separate provision strengthening Medicaid program integrity through continuous levies on provider payments, but this does not alter patient coverage. All key provisions take effect on January 1, 2024.

Maddy summaryHR 1610 would modernize Medicare coverage for chiropractic care by removing the current restriction that limited beneficiaries to one chiropractic service per visit. It expands coverage to include all services provided by licensed chiropractors within their state-authorized scope, aligning Medicare with VA, military, and private insurance practices. The bill requires chiropractors to complete a Secretary-approved educational webinar to cover non-spinal services, while still allowing payment for spinal manipulation treatments without this requirement. This directly affects Medicare beneficiaries seeking chiropractic care and chiropractors seeking Medicare reimbursement for their services.

Maddy summaryThe Affordable Insulin Now Act (HR 1488) requires health insurance plans and issuers to cover specific insulin products with cost-sharing capped at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, starting in 2024. It directly affects people with diabetes who rely on insulin by limiting out-of-pocket costs for covered products. The bill mandates coverage of all insulin types (rapid-acting, long-acting, etc.) and dosage forms (vials, pumps, etc.) as selected by the plan. This applies to both group and individual health insurance plans under the Public Health Service Act, Internal Revenue Code, and ERISA, with cost-sharing counting toward annual deductibles.

Maddy summaryThis bill requires Medicare and Medicaid to cover prescription digital therapeutics - software-based treatments for medical conditions like diabetes or mental health disorders - starting January 1, 2024. It mandates Medicare to establish payment rates for manufacturers within one year and create specific billing codes within two years, with temporary codes used until permanent codes are set. Manufacturers must report annual data on pricing, usage, and discounts to Medicare, facing penalties of up to $10,000 per day for incomplete or false reports. The bill directly affects Medicare/Medicaid beneficiaries, digital therapeutic companies, and the healthcare billing system by integrating these treatments into federal coverage.

Maddy summaryHR 1401, the END FENTANYL Act, requires U.S. Customs and Border Protection (CBP) to review and update its field inspection manuals at least every three years. This ensures CBP's border inspection practices consistently address new smuggling methods used to hide drugs like fentanyl and human trafficking. The bill mandates that CBP submit reports to specific congressional committees after each update, detailing the changes made to inspection policies. This directly affects CBP officers and border security operations by standardizing how they detect and respond to evolving smuggling tactics.

Maddy summaryThis bill makes permanent Medicare coverage for cardiac and pulmonary rehabilitation services delivered via telehealth in patients' homes, which were temporarily allowed during the pandemic. It removes geographic restrictions that previously required in-person visits or limited services to specific locations like clinics. The change directly affects Medicare beneficiaries needing heart or lung rehabilitation and healthcare providers offering these programs. It ensures home-based telehealth visits for cardiac, intensive cardiac, and pulmonary rehabilitation receive the same coverage as in-clinic services under Medicare.

Maddy summaryThe Stop the Wait Act of 2023 eliminates the current 5-month waiting period for Social Security Disability Insurance (SSDI) benefits by phasing it out: applications filed in 2023-2025 would face a 3-month wait, 2026 a 2-month wait, and 2027 a 1-month wait, with full elimination by January 2028. It also changes Medicare rules to allow individuals without minimum essential health coverage to receive Medicare benefits retroactively from the first month of SSDI eligibility, rather than waiting 24 months. This directly affects people under 65 applying for SSDI who lack other health insurance, ensuring they have coverage during the waiting period. The bill amends the Social Security Act to implement these changes, effective January 1, 2028.