Rep. Brandon Williams

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic prior authorization systems by 2027 and publish detailed data on their approval and denial rates for medical services by 2026. It directly affects Medicare Advantage plans (private insurers offering Medicare coverage) and their enrollees (seniors 65+), mandating transparency about prior authorization decisions, processing times, and appeal outcomes. Key provisions include requiring plans to report annual statistics on request approvals/denials, average processing times, and use of technology, with this data published publicly by the Centers for Medicare & Medicaid Services. The bill also sets timelines for plan responses to prior authorization requests and mandates reports to Congress on implementation and impacts.

Maddy summaryThis bill protects small businesses from higher unemployment insurance premiums by exempting them from calculations tied to unrepaid state loans. Specifically, it amends tax code provisions so businesses with fewer than 500 employees (as measured at year-end) cannot have their premiums increased due to unpaid state advances. The change applies to taxable years starting after the bill becomes law, directly affecting qualifying small businesses that would otherwise face higher costs. This is a technical adjustment to existing tax code rules, not a new benefit or funding mechanism.

Maddy summaryThis bill corrects payment calculations for Medicare Advantage (MA) plans in service areas where wage index increases exceeded 20% in prior years, addressing an underestimation in growth projections. It requires the Medicare Secretary to adjust 2025 and prior year (back to 2024) payment growth rates for affected plans to reflect actual local wage trends. The adjustment applies specifically to MA local plans in service areas with significant average wage index increases. This ensures payments better match actual cost growth in those regions, with changes implemented immediately for 2025 rates.

Maddy summaryThe Essential Caregivers Act of 2024 requires nursing homes and similar facilities to allow residents to designate essential caregivers who provide emotional support or assistance with daily activities. During emergencies when regular visitation is restricted, facilities must permit at least one essential caregiver access to residents daily and cannot deny access without following specific procedures. Facilities may deny access for a maximum of 7 days during emergencies (or 14 days with state approval), and must provide a written explanation and appeal process if access is denied. The bill establishes a 48-hour appeal process for residents and caregivers to challenge denials, with facilities required to prove violations during appeals. This law applies to Medicare skilled nursing facilities, Medicaid nursing facilities, intermediate care facilities, and certain inpatient rehabilitation facilities.

Maddy summaryThe Responsible Use of Seafloor Resources Act of 2024 directs the President to coordinate federal agencies in supporting U.S. development of seafloor nodule collection and domestic processing for critical minerals used in defense and clean energy. It mandates annual reports analyzing the environmental, social, and economic impacts of seafloor minerals compared to land-based mining, including job creation and ecosystem effects. The reports will assess how U.S. sourcing aligns with security goals and international standards, while tracking benefits like supply chain diversification and reduced reliance on foreign sources.

Maddy summaryHR 7442 directs the Government Accountability Office (GAO) to study whether Medicare could cover medical services provided in the Philippines for beneficiaries already enrolled in Medicare Part B or Part C. The study must analyze potential cost savings compared to U.S. care (2025-2034) and identify required legislative/administrative changes to expand coverage. This bill only authorizes a study and does not change current Medicare benefits or eligibility.

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 summaryHR 5408, the SSI Savings Penalty Elimination Act, increases the resource limits for Supplemental Security Income (SSI) program eligibility. It raises the individual resource limit from $2,250 to $20,000 (and the couple limit from $1,500 to $10,000) for 2023, with future annual increases tied to inflation using the Consumer Price Index. This change directly affects low-income SSI recipients who currently lose benefits if their savings exceed the current thresholds. The key mechanism is raising these savings limits to reduce the "penalty" for saving modest amounts, while maintaining program integrity through automatic inflation adjustments.

Maddy summaryThis bill prevents Medicare from imposing stricter supervision requirements for outpatient physical therapy and occupational therapy than those established by state law, requiring Medicare to follow existing state regulations instead. It takes effect January 1, 2024, directly affecting Medicare-covered therapy services in all states. Additionally, it mandates a Government Accountability Office study by December 2024 to analyze how Medicare’s 15% payment differential for therapy assistants impacts access to care in rural and underserved areas. The study will examine this payment policy across all Medicare Part B settings.

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.