Rep. Nicole Malliotakis

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.

Maddy summaryThis bill, HR 6860, protects patients with end-stage kidney disease (ESRD) who require dialysis by preventing health insurance plans from discriminating against them. It amends Medicare rules to prohibit plans from treating dialysis coverage differently than other medical services based on a patient’s ESRD diagnosis, need for dialysis, or any other factor. The bill clarifies that plans can still choose which dialysis providers to include in their networks but cannot deny or limit coverage for dialysis services solely because of the patient’s condition. It ensures Medicare remains the secondary payer for these services as intended, without forcing plans to cover specific providers.

Maddy summaryHR 6780 establishes a 4-year Medicare demonstration program testing whether hospitals providing medically tailored home-delivered meals to specific patients improves health outcomes and reduces hospital readmissions. The program targets Medicare beneficiaries with diet-sensitive chronic conditions (like diabetes or heart failure) who are at high risk of readmission and meet specific discharge criteria, such as limited daily living activities. Selected hospitals must screen patients, provide at least two tailored meals daily for 12 weeks, and offer medical nutrition therapy, all without patient cost-sharing. The program requires hospitals to submit data for evaluation, with the goal of assessing impacts on hospital admissions, care costs, and patient satisfaction before reporting to Congress in 2027 and 2030.

Maddy summaryThe Preserving Seniors’ Access to Physicians Act of 2023 increases the Medicare payment adjustment rate for physicians from 1.25% to 4.62%, directly affecting doctors who treat Medicare patients (primarily seniors). It also reduces the funding for the Medicaid improvement fund from $5,796,117,810 to $3,973,117,810. These changes impact Medicare providers and Medicaid programs, with the Medicare adjustment aimed at supporting physicians adjusting to payment changes. The bill does not specify how the Medicaid funding reduction relates to its stated goal of preserving seniors' access to physicians.

Maddy summaryThis bill amends customs fee rules to allow U.S. Customs and Border Protection (CBP) to adjust merchandise processing fees to cover capital costs like equipment upgrades and facility construction/maintenance at sea ports of entry. It requires CBP to submit annual reports detailing how fee proceeds are used for port infrastructure and outlining remaining capital needs. The bill also prohibits CBP from requiring sea ports to provide administrative, training, or recreational facilities for CBP operations. These provisions aim to improve CBP's funding transparency and infrastructure planning at border ports.

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.

Maddy summaryThe Maximum Pressure Act (HR 6114) is a legislative proposal that would maintain and expand U.S. sanctions against Iran. The bill would codify existing sanctions, require Iran to meet 12 specific conditions before sanctions could be lifted (including ending support for terrorism, releasing hostages, and ending nuclear enrichment), and expand sanctions on Iran's Revolutionary Guard Corps and missile programs. It also establishes new reporting requirements for the U.S. government to monitor Iran's activities and the impact of sanctions. The legislation would require congressional review before any sanctions could be lifted or modified, preventing the executive branch from unilaterally easing restrictions.

Maddy summaryThe PILLS Act creates tax credits to encourage domestic production of generic drugs and biosimilars. It provides a production credit (up to 35% of value added for final drug production) for manufacturers producing eligible drugs in the U.S., with additional bonus credits for domestically sourced materials. The bill also establishes a 25% investment credit for qualified facilities building new production capacity, with both credits phasing out after 2029 and terminating for new construction after 2027. These provisions directly affect U.S. pharmaceutical manufacturers of generic drugs and biosimilars, aiming to increase domestic supply of these medications.

Maddy summaryThis bill, titled "Freezing HAMAS Act" (though it concerns Iran sanctions, not Hamas), reinstates U.S. sanctions on Iran that were previously waived or suspended under agreements with Iran. It specifically targets sanctions from the 2012 Iran Freedom and Counter-Proliferation Act and the 2012 National Defense Authorization Act, including a September 2023 waiver related to fund transfers. The bill prohibits the U.S. government from releasing funds or assets to Iran or granting further waivers related to these sanctions. It directly affects U.S. government actions regarding Iran financial transactions and enforcement of existing sanctions.

Maddy summaryHR 5912 (PUNISH Act of 2023) maintains existing U.S. sanctions against Iran by preventing the President from lifting them without new certification. It requires the State Department to submit every 180 days a report confirming Iran has not engaged in targeted violence (such as assassinations of U.S. citizens, Iranian residents in the U.S., or politically motivated abuse) over the past five years. This certification must be provided before sanctions can be waived, suspended, or reduced under current laws like the Iran Sanctions Act. The bill directly affects the President’s authority to ease sanctions, Iranian entities subject to existing sanctions, and U.S. agencies responsible for reporting. It does not create new sanctions but extends the duration of current measures until a specific certification date.