Rep. Valerie P. Foushee

Maddy summaryHR 3851, the Access to Breast Cancer Diagnosis Act of 2023, requires most health insurance plans (including group and individual coverage) to cover diagnostic and supplemental breast exams without any out-of-pocket costs like copays or deductibles. This applies to medically necessary exams used to evaluate abnormalities detected during screening (diagnostic) or to screen high-risk individuals without abnormalities (supplemental), following National Comprehensive Cancer Network guidelines. Plans may still require prior authorization for these exams, and state laws providing stronger protections remain in effect. The law takes effect for plan years beginning January 1, 2024.

Maddy summaryThis bill simplifies regulations for rural health clinics (RHCs) by reducing administrative burdens. It allows RHCs to contract with physician assistants and nurse practitioners (instead of requiring direct employment), updates the definition of "rural" to exclude areas with 50,000+ residents, and removes outdated lab service requirements by requiring only "prompt access" to clinical labs. These changes directly affect RHCs, enabling them to more flexibly staff and operate while complying with state practice laws. The amendments take effect January 1, 2024, applying to services provided on or after that date.

Maddy summaryThe FAMILY Act (HR 3481) would establish a national paid family and medical leave insurance program administered by the Social Security Administration. Eligible workers would receive wage replacement benefits (up to 85% of average earnings, with a maximum of $4,000 monthly) for up to 60 caregiving days per 12-month benefit period for qualifying reasons like caring for a sick family member, personal serious health conditions, or responding to domestic violence. The program would be funded through 0.2% payroll taxes from employees and employers (with self-employed individuals paying 0.4%), with benefits coordinated with existing state programs. The law includes protections against employer retaliation for taking leave and requires employers to maintain health coverage during leave periods.

Maddy summaryHR 3432, the Telemental Health Care Access Act of 2023, expands Medicare coverage for mental and behavioral health services delivered via telehealth. It removes geographic restrictions that previously limited telehealth coverage to rural areas and explicitly adds "behavioral health services" to the list of covered telehealth services under Medicare Part B. The bill requires the Secretary of Health and Human Services to submit a report within one year on utilization of these services, including recommendations on fraud prevention and funding needs for oversight. This change directly affects Medicare beneficiaries seeking remote mental/behavioral health care and the providers who deliver it.

Maddy summaryThe Medicare for All Act would establish a single-payer national health insurance program providing comprehensive coverage to all U.S. residents without cost-sharing. It would replace current private insurance and government programs like Medicare and Medicaid with a unified system covering all medically necessary services including hospital care, prescription drugs, mental health services, reproductive care, long-term care, and preventive services. The bill prohibits private insurers from offering duplicate coverage and requires providers to participate without charging patients for covered services. Implementation would occur over a two-year transition period, with a "Medicare Transition Buy-In" option allowing people to enroll before full implementation.

Maddy summaryThis bill establishes minimum nurse-to-patient ratios for registered nurses in hospital units (such as 1:1 in trauma units, 2:1 in critical care units, and 3:1 in emergency rooms), requiring hospitals to develop and maintain staffing plans that meet these standards. It mandates transparency in documenting staffing levels, ensures hospitals verify nurses' competence for specific units, and enforces compliance through Medicare and Medicaid programs with penalties for violations. The bill protects nurses who refuse unsafe assignments due to staffing concerns and includes initiatives to improve nurse retention and address staffing shortages. It directly affects hospitals, nurses, and patients by aiming to improve patient safety and care quality through standardized staffing requirements. The bill applies to all hospitals, with extended implementation timelines for rural facilities.

Maddy summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

Maddy summaryThis bill would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.

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 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.