Maddy summaryHR 6283, the DRUG Act, regulates pharmacy benefit managers (PBMs) to prevent practices that may increase prescription drug costs for consumers. The bill prohibits PBMs from earning revenue based on drug prices or discounts, requiring them to charge flat dollar service fees instead of fees tied to drug costs. It bans PBMs from steering patients to pharmacies they own or control, mandates equal reimbursement for affiliated and non-affiliated pharmacies, and prohibits charging different fees for the same drug. These provisions apply to group health plans, health insurance issuers, and PBMs, with enforcement beginning for plan years starting January 1, 2026. Violations would result in $10,000 daily penalties and require disgorgement of improperly received payments.
Rep. Mikie Sherrill
Sponsored bills
Maddy summaryThis bill amends Medicare, Medicaid, and private insurance rules to improve coverage for drugs treating rare diseases (defined as conditions affecting 200,000 or fewer people in the U.S.). It requires coverage for rare disease drug uses supported by peer-reviewed medical literature and not listed as contraindicated in FDA labeling or medical reference guides. Private insurers must provide expedited review processes for denials of such drugs. The changes apply 30 days after enactment, affecting insurers and patients seeking coverage for rare disease treatments.
Maddy summaryThe Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.
Maddy summaryThis bill requires most health insurance plans (both employer-sponsored and individual plans) to cover a full year's supply of contraceptives in a single prescription, without any extra costs to the patient. It directly affects individuals enrolled in group health plans or individual health insurance coverage who need contraceptive services. The key provision allows enrollees to obtain up to 365 days of contraceptive supply at once (instead of monthly refills) at no additional cost, aligning with existing coverage requirements under the law. The rule takes effect for plan years starting January 1, 2024.
Maddy summaryHR 4752 (the CHANGE Act of 2023) requires Medicare to include standardized cognitive impairment screening during annual wellness visits and initial preventive physical exams for beneficiaries starting in 2024. It mandates doctors use National Institute on Aging-approved tools to detect memory issues and document results in medical records. This directly affects Medicare patients aged 65+ and their healthcare providers, aiming to enable earlier Alzheimer’s diagnosis and care planning. The bill focuses on making routine screenings a standard part of Medicare-covered checkups, not on funding or new programs. It does not alter existing Medicare benefits but adds a specific screening requirement to two existing service categories.
Maddy summaryThis bill strengthens the U.S. law preventing imports made with forced labor from Xinjiang by expanding definitions of forced labor programs to include specific Chinese government initiatives like "surplus labor transfer," "Xinjiang Aid," and "re-education programs." It requires the U.S. government to update its strategy to align with U.S. Customs determinations about goods from Xinjiang and mandates detailed public lists of entities recruiting, transporting, or receiving forced labor outside Xinjiang. The law directly affects U.S. importers who must verify supply chains and Chinese entities operating labor programs in Xinjiang. Key provisions include broadening the scope of "forced labor" to cover state-imposed programs targeting Uyghurs and other minorities, and requiring transparency about entities linked to these programs.
Maddy summaryThe BLUE Pacific Act establishes a comprehensive U.S. strategy to deepen engagement with Pacific Island nations through coordinated assistance across multiple policy areas. It authorizes $250 million annually for fiscal years 2023-2033 to support initiatives in climate resilience, economic development, security capacity building, public health, and democratic governance. The act requires the President to develop a Pacific Islands Partnership Strategy by 2027, with regular congressional reporting, and mandates consultation with Pacific Island nations and regional organizations. This legislation formalizes U.S. efforts to support Pacific Island countries in addressing shared challenges like climate change, economic development, and security while strengthening regional partnerships. The strategy will guide U.S. assistance across multiple agencies to support Pacific Island nations' priorities as outlined in regional frameworks like the 2050 Strategy for the Blue Pacific Continent.
Maddy summaryHR 4475, the Period PROUD Act of 2023, allocates $1.9 billion over four years (2025-2028) through the Social Services Block Grant Program to provide free menstrual products to low-income menstruating individuals. It requires states to distribute funds to qualified nonprofits for direct product distribution, community outreach, and improving access, while limiting administrative costs to 9% of funds. The bill mandates an evaluation by 2030 to assess health impacts and requires annual reports on program effectiveness. It also establishes best practices for schools on discussing menstruation and exempts funding from automatic budget cuts.
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 summaryThe PrEP Access and Coverage Act of 2023 requires private health insurance plans, Medicare, Medicaid, and other public health programs to cover pre-exposure prophylaxis (PrEP) for HIV prevention without cost-sharing, including the medication, related lab tests, and follow-up care. The bill also prohibits life, disability, and long-term care insurance companies from denying coverage or charging higher premiums to people taking PrEP. It establishes public education campaigns to increase awareness of PrEP and PEP (post-exposure prophylaxis) and creates funding for state and community programs to expand access to HIV prevention services, particularly for populations disproportionately affected by HIV including Black, Hispanic/Latinx, and transgender individuals. The legislation specifically addresses current disparities in PrEP access, as data shows only 11% of Black/African American and 21% of Hispanic/Latinx individuals eligible for PrEP received prescriptions in 2022 compared to 82% of White individuals. Coverage requirements for most plans will take effect on January 1, 2025.