Rep. Paul Tonko

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 eliminates a 190-day lifetime limit on inpatient psychiatric hospital services covered by Medicare. It directly affects Medicare beneficiaries requiring long-term inpatient mental health treatment, allowing them access to necessary care without the previous cap. The key provision amends Section 1812 of the Social Security Act to remove the lifetime limit, effective January 1, 2025. This change ensures continuous coverage for psychiatric hospital stays as needed, rather than restricting access after a set number of days.

Maddy summaryThe Lowering Drug Costs for American Families Act expands Medicare's drug price negotiation program from 20 to 50 drugs, allowing the government to negotiate lower prices for these medications. It requires private health insurance plans and group health coverage to apply these negotiated prices to their members' cost-sharing for covered drugs, with plans able to opt out while publicly disclosing their decision. The bill also extends these negotiated prices to drugs covered by commercial insurance markets, not just Medicare. This would directly affect Medicare beneficiaries and people with private health insurance who take the negotiated drugs.

Maddy summaryThe 9-8-8 Implementation Act of 2023 establishes a national mental health crisis response system centered around the 9-8-8 suicide prevention hotline. It provides $441 million for call center technology, staffing, and operations, and requires Medicare, Medicaid, and private health plans to cover crisis response services including mobile crisis teams and crisis stabilization facilities. The bill also mandates a national suicide prevention media campaign and creates protocols for 9-1-1 dispatchers to better respond to mental health crises. These provisions aim to improve access to mental health crisis care across the United States.

Maddy summaryThe Physical Therapist Workforce and Patient Access Act of 2023 expands the National Health Service Corps to include physical therapists in its loan repayment program and creates designated "physical therapy health professional target areas" for their assignment in underserved communities. It also amends Medicare to cover physical therapy services provided by physical therapists at Rural Health Clinics and Federally Qualified Health Centers, effective January 1, 2025. This directly affects physical therapists by offering new career pathways in underserved areas and patients in those communities by increasing access to physical therapy services for conditions like pain management and rehabilitation. The bill does not alter existing eligibility requirements for physical therapists but formally integrates their services into key federal healthcare programs.

Maddy summaryThe Breast Cancer Patient Equity Act would require Medicare to cover custom-made breast prostheses for women who have undergone mastectomies, directly affecting Medicare beneficiaries and influencing private insurance coverage practices. Currently, Medicare denies coverage for these prostheses as "not medically necessary" while covering surgical breast reconstruction, creating a gap that disproportionately impacts older and minority women. The bill amends Medicare’s coverage rules to explicitly include custom breast prostheses under the same category as other body part prostheses. This change would address the lack of access to a common, less invasive alternative to surgery for over 100,000 women undergoing mastectomies annually.

Maddy summaryThe Social Security 2100 Act would significantly enhance Social Security benefits for millions of Americans by increasing monthly payments for retirees, disabled workers, widows/widowers, and children. Key provisions include raising the minimum benefit for long-term low earners, improving cost-of-living adjustments using a more accurate index, eliminating the 5-month waiting period for disability benefits, and extending child benefits to age 26. The bill also changes how Social Security taxes are calculated by applying them to income above $400,000 and establishes a unified Social Security Trust Fund to manage program finances. Most provisions would apply to benefits payable from 2025 through 2034, affecting all current and future Social Security beneficiaries.

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 summaryThis bill, the Public Servants Protection and Fairness Act of 2023, amends Social Security to better protect public servants who work in jobs not covered by Social Security (such as certain government positions). It creates a new formula for calculating retirement benefits that combines both covered and noncovered earnings, ensuring public servants receive the higher of two benefit calculations. The bill also provides an additional $150 monthly payment for certain public servants whose benefits were previously reduced by the windfall elimination provision. It improves Social Security account statements to clearly show noncovered earnings and requires a study of how state retirement plans handle these benefits. These changes will apply to benefits starting in 2025.