Rep. Joseph D. Morelle

Maddy summaryThis bill creates a new Medicare payment model for emergency medical services (EMS) that allows coverage when ambulance providers deliver critical care on-site without transporting patients to a hospital. It directly affects Medicare beneficiaries receiving such on-site emergency care and ambulance providers who would previously not be reimbursed for non-transport services. The key provision requires Medicare to pay for these services at rates matching what would have been paid for transport, based on state protocols and emergency call responses, for a 5-year trial period. A report due 4 years after implementation will evaluate impacts on patient outcomes, system efficiency, and regional access.

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 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 Telehealth Modernization Act of 2024 extends Medicare's temporary telehealth coverage rules permanently, removing the previous 2024 expiration date. It expands who can provide telehealth services by allowing more healthcare professionals (like certain nurse practitioners) to bill Medicare for these services, and ensures Federally Qualified Health Centers and Rural Health Clinics can continue billing for telehealth under existing payment rules after 2024. The bill also explicitly permits audio-only telehealth calls for Medicare coverage and allows telehealth for hospice face-to-face visits and home dialysis assessments as clinically appropriate, without time limits. These changes directly affect Medicare beneficiaries, healthcare providers, and community health centers offering telehealth services.

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 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 summaryThis bill prohibits health insurance plans from charging healthcare providers fees for electronic payments (EFTs) and payment advice transactions. It directly affects doctors, hospitals, and clinics that receive electronic payments from health plans by banning any charges, including withholdings, for these transactions. The law, effective January 1, 2024, amends the Social Security Act to require health plans to cover these costs themselves, eliminating fees for providers.

Maddy summaryHR 6417 amends the existing "Ending Importation of Russian Oil Act" to ban imports of energy products (classified under Harmonized Tariff Schedule chapter 27) produced at any refinery using crude oil originating in Russia. This directly affects U.S. importers and companies bringing in such refined petroleum products. The key provision prohibits these imports regardless of where the refinery is located, targeting oil that has been "laundered" through foreign processing. The bill updates the existing law by adding this origin-based import ban as a new section.

Maddy summaryThe ARCC Act provides $100 million in federal funding to help apprentices and pre-apprentices in job training programs cover childcare costs. It authorizes competitive grants to 10 states, which must distribute monthly stipends of at least $500 per dependent child directly to eligible childcare providers on behalf of participants in these programs. The bill prioritizes individuals from historically underrepresented groups (based on race, ethnicity, or gender) and ensures stipends are tax-free while not affecting eligibility for other federal benefits. States must report on participation, program completion rates, and demographic data, with the Secretary later summarizing program impacts for Congress.

Maddy summaryThis bill updates Medicare physician payment rules to improve stability and accuracy. It raises the budget neutrality threshold from $20 million (pre-2025) to $53 million in 2025, with annual indexing after 2026, to prevent excessive payment adjustments. The bill requires the Medicare program to correct budget neutrality payments based on actual service utilization data (not estimates) starting in 2025, and mandates updating direct cost inputs (like staff wages and equipment prices) every 5 years. It also caps annual changes to the physician payment conversion factor at 2.5% to limit sudden payment shifts, directly affecting Medicare physicians and healthcare providers receiving these payments.