Rep. Paul Tonko

Maddy summaryThe ROCR Value Based Program Act establishes a new Medicare payment system for radiation oncology services, replacing the current fee-for-service model with a per-episode payment structure. This program affects radiation therapy providers (hospital outpatient departments) and suppliers (physician practices or freestanding centers) treating Medicare beneficiaries with specific cancer types (including breast, prostate, lung, and brain metastases). Key provisions include 80% of the payment being paid upfront within 30 days of treatment start, with the remaining 20% paid later; a health equity add-on payment of $500 per patient for transportation services to patients reporting transportation insecurity (using ICD-10 code Z59.82); and quality incentives for accredited providers through a 0.5% payment increase for meeting accreditation requirements. The program aims to stabilize payments, improve access to radiation therapy, enhance quality, leverage technology, and contain costs while maintaining Medicare savings.

Maddy summaryThe State Public Option Act creates a new Medicaid buy-in program allowing individuals without other health insurance to purchase coverage starting January 1, 2025. This program limits premiums to 8.5% of household income and requires states to cover comprehensive sexual and reproductive health services, including abortion, beginning in 2025. The bill also establishes how Affordable Care Act premium tax credits apply to this coverage and includes provisions for quality measures and payment rates for primary care services under Medicaid.

Maddy summaryThis bill updates the Supplemental Security Income (SSI) program to better support low-income elderly, blind, and disabled individuals. It raises key financial thresholds: the resource limit for single individuals increases from $2,250 to $20,000 (adjusted annually for inflation), and the general income exclusion rises from $240 to $1,797 per month. The bill also removes a penalty that reduced benefits for married couples, excludes retirement accounts and tribal general welfare payments from resource calculations, and eliminates outdated requirements like dedicated accounts for past-due benefits. These changes directly affect SSI recipients by making it easier to qualify and maintain benefits without losing support due to minor income or resource fluctuations.

Maddy summaryThis bill amends Medicare eligibility rules to explicitly include occupational therapy as a qualifying service for home health care. It changes the Social Security Act to state that beneficiaries need "occupational, or speech therapy" (instead of only "speech therapy") to qualify for home health services. This change directly affects Medicare beneficiaries requiring occupational therapy at home, expanding access to this specific care. The policy takes effect for services provided on or after January 1, 2025.

Maddy summaryHR 7119, the Fairness in Nursing Home Arbitration Act, prohibits nursing homes and providers of home health or community-based care from requiring residents or patients to sign arbitration agreements before any dispute arises. It directly affects residents of skilled nursing facilities (covered under Medicare) and individuals receiving home health or nursing care (covered under Medicaid), preventing facilities from enforcing such agreements for current or former patients. The key provision bans the use of pre-dispute arbitration agreements entirely, making them invalid and unenforceable, and ensures courts - not arbitrators - decide disputes related to these agreements. The bill applies to all service providers, including their employees and affiliates, and takes effect upon enactment.

Maddy summaryThis bill adds 1,000 new medical residency positions (500 in 2024 and 500 across 2025-2028) specifically for training in addiction medicine, addiction psychiatry, or pain medicine. It directly affects hospitals that have or will establish approved residency programs in these fields. Hospitals receiving these positions must use them for addiction-related training for five years, with unused positions redistributed if requirements aren't met. The goal is to expand the healthcare workforce addressing the substance use disorder crisis by increasing specialized training opportunities.

Maddy summaryThe Nutrition CARE Act of 2024 expands Medicare Part B coverage to include medical nutrition therapy services for beneficiaries diagnosed with eating disorders. It directly affects Medicare beneficiaries with eating disorders - particularly an estimated 420,500-560,700 Black, Indigenous, and People of Color seniors - by requiring coverage for 13 hours of initial care (including assessment) and 4 hours annually for ongoing management. The bill amends Medicare law to specify that these services must be provided by registered dietitians or nutrition professionals following referrals from physicians or psychologists. Coverage applies to all eating disorders as defined by the DSM-5, addressing a gap where Medicare previously excluded this critical treatment component. This policy change aims to improve access to evidence-based care for a condition linked to high mortality and significant healthcare costs.

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 6790 establishes National Institutes of Health centers to advance research, early detection, and public awareness of rare kidney diseases, with a focus on rural and underserved communities. It mandates a federal study on genetic testing barriers, treatment patterns, and public awareness for rare kidney diseases affecting disproportionately impacted populations, including barriers to insurance coverage and access to specialists. The bill also funds nephrology training programs to increase specialists serving these communities and requires experiments to delay or prevent the need for dialysis and transplants. Total funding of $7 million is authorized for fiscal years 2024-2028 to support these research, education, and early intervention efforts.

Maddy summaryThe FOREST Act of 2023 prohibits U.S. imports of products made from commodities (palm oil, soybeans, cocoa, cattle, and rubber) produced on land where illegal deforestation occurred after the law's enactment. Importers must file declarations demonstrating they've assessed supply chain risks of illegal deforestation, with stricter requirements for products from countries identified in action plans. The law establishes a process to identify countries without adequate deforestation protections and requires them to develop action plans with specific benchmarks for compliance. It creates a fund using import penalty revenue to provide foreign assistance to help countries eliminate illegal deforestation and includes procurement preferences for federal contracts with suppliers demonstrating deforestation-free supply chains.