Maddy summaryThis bill expands Medicare coverage for in-home administration of intravenous immune globulin (IVIG) to include treatment for chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN), effective January 1, 2026. It amends Medicare law to add these conditions to the list of covered primary immune deficiency diseases, directly affecting Medicare beneficiaries with CIDP or MMN who currently lack coverage for in-home IVIG. The bill also allows Medicare payment adjustments based on whether IVIG is used for primary immune deficiency or these new neurological conditions, as determined by the Secretary through formal rulemaking. This creates a specific policy change to broaden access for two neurological conditions previously excluded from in-home IVIG coverage.
Rep. Brian K. Fitzpatrick
Sponsored bills
Maddy summaryThis bill (HR 5752) modifies health insurance rules to improve access to mental health care. It prevents health insurance plans from being classified as "high deductible" if they waive deductibles for the first $500 of mental health benefits (like therapy or counseling) each year. This change directly affects health insurance plans and their members, ensuring those plans can still qualify as high deductible plans while offering more accessible initial mental health coverage. The provision applies to plan years starting after December 31, 2023.
Maddy summaryThis bill provides continuing appropriations for federal government operations through January 11, 2024, ensuring funding for ongoing programs and activities. It includes $16 billion for disaster relief and over $21 billion in supplemental funding for Ukraine assistance, covering military aid, economic support, and humanitarian programs. The bill also extends funding for community health centers, Federal Aviation Administration programs, and the Temporary Assistance for Needy Families program through the same date. These funding measures maintain government operations and support critical domestic and international programs during the fiscal year.
Maddy summaryHR 5663, the ALS Better Care Act, creates a new Medicare payment system to improve reimbursement for specialized care services provided to ALS patients. It establishes a $800 per visit payment rate starting in 2025 for qualified ALS care facilities, with annual increases based on market basket adjustments. The bill requires the Comptroller General to report on appropriate payment amounts and ensures this new payment is in addition to, not replacing, existing Medicare payments for ALS-related services. This aims to reduce wait times, support facilities in rural areas through telehealth access, and address funding challenges for ALS clinical trials.
Maddy summaryThis bill makes permanent Medicare coverage for telehealth services provided by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), including audio-only visits. It directly affects Medicare beneficiaries who use these services and the FQHCs/RHCs delivering them by removing location restrictions - allowing telehealth visits to occur regardless of the patient's geographic location. Key provisions include permanently covering audio-only telehealth (previously temporary), treating telehealth visits as equivalent to in-person visits for payment, and ensuring costs for telehealth are included in FQHC/RHC payment calculations. These changes simplify access to telehealth for rural and underserved communities while maintaining consistent Medicare reimbursement for providers.
Maddy summaryThe ORPHAN Cures Act amends the Drug Price Negotiation Program under the Social Security Act to clarify how orphan drugs (medications for rare diseases affecting fewer than 200,000 people in the U.S.) are treated. It ensures that periods when a drug was designated as an orphan drug are excluded from the time calculation used to determine when the drug can no longer be excluded from price negotiations. The bill also updates the definition to allow a single drug to be designated for multiple rare diseases, rather than just one. This change provides clearer rules for manufacturers and the government regarding orphan drug exclusions in the program.
Maddy summaryThis bill clarifies that Medicare must cover external infusion pumps and associated non-self-administrable drugs as durable medical equipment (DME) when specific criteria are met. It directly affects Medicare beneficiaries requiring home infusion therapy for drugs that must be prepared just before use, administered by a healthcare professional, or labeled for external pump use at least monthly. Key provisions require the drug's FDA labeling to specify external pump administration, safe home delivery by qualified suppliers, and preparation/administration requirements. The bill mandates Medicare coverage under existing rules (LCD L33794) for qualifying treatments, effective upon enactment or FDA approval, whichever is later.
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 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.