Rep. Yvette D. Clarke

Maddy summaryHR 5183, the Cancer Care Planning and Communications Act, requires Medicare to cover "cancer care planning and coordination services" for beneficiaries diagnosed with cancer. This policy directly affects Medicare patients with cancer, particularly older adults (over half of cancer diagnoses occur in Medicare beneficiaries), by mandating written care plans developed by physicians or providers. The key mechanism adds specific coverage for these plans under Medicare, requiring them to document treatment options, coordinate care across providers, and address symptoms like pain or fatigue - furnished in culturally appropriate formats. The bill specifies payment rates matching existing transitional care management services, effective for care starting after the law's enactment.

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 summaryThe WISE Act of 2023 aims to remove barriers for immigrant survivors of domestic violence, sexual assault, human trafficking, and other crimes who are eligible for protections under the Violence Against Women Act (VAWA) and Trafficking Victims Protection Act (TVPA). Key provisions include reforming U visa eligibility to include civil violations related to abuse, eliminating annual U visa caps, and automatically granting work authorization to applicants within 180 days of filing. The bill also prohibits detention of these survivors while their applications are pending and expands protections for battered spouses, children, and abused derivative aliens seeking immigration relief. This directly affects non-citizen victims of violence who are navigating complex immigration processes to remain safely in the United States.

Maddy summaryThis bill simplifies participation in Medicare's Accountable Care Organization (ACO) program by removing distinctions between small and large ACOs and eliminating the requirement for new ACOs to assume financial risk for three years before joining shared savings models. It creates a new "100% shared savings" option where ACOs keep all savings from cost reductions but bear full financial responsibility for losses. The bill also mandates clearer, transparent benchmark calculations for ACO performance, establishes appeal processes for disputed benchmarks, and requires technical assistance for rural and underserved providers. These changes directly affect Medicare ACOs, particularly smaller or newer organizations in rural or safety-net settings, aiming to make value-based care participation more accessible.

Maddy summaryThis bill creates an exemption for Medicare Advantage plan physicians who had at least 90% of their prior authorization requests approved for specific services in the previous year. These doctors would be exempt from needing pre-approval for those same services in subsequent plan years, reducing administrative delays for patients. The exemption continues until revoked (based on updated approval rates) or the physician opts out. It also requires plans to allow providers to discuss treatment plans with a qualifying physician during the authorization process.

Maddy summaryThis bill expands Medicare benefits for chronic kidney disease patients by adding kidney disease screening to annual wellness visits and broadening education options to include more healthcare professionals like nurse practitioners. It updates payment systems to better cover innovative kidney treatments, including new drugs and devices, and requires a study on increasing kidney transplant rates. The bill also aims to improve the kidney care workforce by expanding training opportunities in underserved areas and ensures Medicare Advantage plans properly cover new kidney therapies. These changes directly affect Medicare beneficiaries with kidney disease, dialysis centers, and nephrology providers, with key provisions taking effect in 2022-2024.

Maddy summaryThe HOPE for Haitian Prosperity Act extends duty-free access for Haitian goods to the U.S. market until 2035, with specific extensions for apparel and other exports. It requires Haitian producers to meet labor standards on minimum wages, working hours, and safe conditions to maintain this trade benefit. The bill also creates a new U.S. technical assistance program to help Haiti diversify exports, focusing on agriculture, apparel, and services, while requiring collaboration with Haitian government, businesses, and labor groups. Annual reports to Congress will track progress on these efforts.

Maddy summaryHR 5008, the HEAL for Immigrant Families Act of 2023, would remove immigration status as a barrier to health insurance coverage for immigrants in the United States. The bill would make all lawfully present immigrants, including those with Deferred Action for Childhood Arrivals (DACA) status, eligible for Medicaid, CHIP, and Affordable Care Act health insurance subsidies. It would eliminate state-level restrictions on Medicaid eligibility for immigrants and allow individuals with federally authorized presence to access premium tax credits and cost-sharing reductions. This legislation aims to address health coverage disparities that disproportionately affect immigrant communities, particularly Black, Indigenous, Latinx, and other communities of color.

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 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.