Rep. Fred Keller

Fairness for Rural Medicare Beneficiaries Act of 2021 This bill modifies the payment methodology and coinsurance amount for outpatient critical access hospital services under Medicare. Currently, the payment rate for such services is 101% of reasonable costs; the coinsurance amount for such services is 20% of the applicable charges. The bill modifies this methodology so as to base the 20% coinsurance amount on the fee schedule under the Medicare outpatient prospective payment system.

EB-5 Reform and Integrity Act of 2021 This bill reauthorizes the EB-5 Regional Center program through FY2026 and makes various changes to the program, such as imposing various oversight requirements. (EB-5 visas provide permanent resident status to qualified alien investors. A regional center allows EB-5 aliens to pool investments to meet various investment and job creation requirements.) Oversight-related provisions include requiring each center to (1) notify the Department of Homeland Security (DHS) of proposed changes to the center's structure, (2) maintain certain records and make such records available to DHS for audits, (3) obtain approval for each particular investment offering, and (4) annually report to DHS. The bill prohibits certain individuals and entities from involvement in a center, such as (1) a person who had committed a violation involving fraud in the previous 10 years, (2) a non-U.S. national not admitted for permanent residence, or (3) a foreign government official. DHS shall deny petitions, such as a petition to certify a regional center or to classify an alien as an alien investor, if approval would threaten U.S. national interest. The bill provides various enforcement authority to DHS and U.S. Citizenship and Immigration Services, including the ability to permanently bar an individual from participating in the regional center program. The bill establishes the EB-5 Integrity Fund to fund program enforcement activities. The bill contains various provisions related to EB-5 petitions, such as a provision authorizing DHS to extend an alien's conditional permanent residence status.

Lower Costs, More Cures Act of 2021 This bill establishes and modifies several programs and requirements to address prescription drug prices. The bill modifies provisions under Medicare and Medicaid relating to prescription drug coverage and price transparency. Among other changes, the bill requires the Centers for Medicare & Medicaid Services to publish certain information, as reported by pharmacy benefit managers (PBMs), relating to generic dispensing rates, drug discounts and rebates, and payments between PBMs, health plans, and pharmacies; caps annual out-of-pocket spending under the Medicare prescription drug benefit; allows prescription drug plan sponsors under the Medicare prescription drug benefit to offer additional plans in a region; requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid; and allows states to include in the Medicaid Drug Rebate Program covered outpatient drugs that are provided as part of physician or outpatient hospital services. The bill also generally modifies other provisions relating to the regulation and costs of generic and brand-name drugs. Among other changes, the bill prohibits the manufacturer of a brand-name, generic, or biosimilar drug from entering into certain agreements to resolve or settle a patent infringement claim in connection with the sale of a drug or biological product; permanently allows high deductible health plans to waive deductibles for insulin and associated products; and establishes the position of Chief Pharmaceutical Negotiator in the Office of the U.S. Trade Representative.

Maximum Pressure Act This bill expands sanctions and economic penalties on Iran. It also restricts the President from unilaterally lifting or waiving the sanctions or penalties and increases congressional oversight of them. Specifically, the bill requires the President to impose visa- and asset-blocking sanctions. Additionally, it modifies existing sanctions, including by (1) providing statutory authority for executive orders imposing sanctions; (2) applying sanctions to additional sectors of Iran's economy; and (3) broadening sanctionable conduct to cover, for example, assisting Iran with the acquisition of ballistic missiles and the complicity of Iranian officials in human rights violations in specified countries. The bill also requires reporting on licenses that authorize activities subject to sanctions. The bill prohibits U.S. representatives at the International Monetary Fund from voting to allow Iran's access to special drawing rights (a currency support tool) and places restrictions on financial transactions with Iran. The restrictions include requiring domestic financial institutions to implement special measures with respect to foreign financial institutions that conduct significant transactions connected to the Instrument in Support of Trade Exchanges (a European mechanism that bypasses U.S. sanctions when carrying out trade with Iran). The Department of State must maintain the Islamic Revolutionary Guard Corps' designation as a terrorist organization and must designate Ansharallah (or Houthis), which operates in Syria, as a foreign terrorist organization. The bill also requires reports on U.S. sanctions concerning Iran, the status of Iran's nuclear weapons program, and other matters.

Protect Our Police Act This bill provides statutory authority for Executive Order 13809, which was issued on August 28, 2017. The order revoked a 2015 executive order establishing an interagency working group to recommend improvements to the process through which state, local, and tribal law enforcement agencies acquire controlled equipment (e.g., firearms or military-style equipment) from the federal government.

Child Interstate Abortion Notification Act This bill creates new federal crimes related to transporting a minor across state lines for an abortion. Specifically, the bill makes it a crime to knowingly transport a minor across a state line to obtain an abortion without satisfying the requirements of a parental involvement law in the minor's resident state. A parental involvement law requires parental consent or notification, or judicial authorization, for a minor to obtain an abortion. The bill prohibits an individual who has committed incest with a minor from knowingly transporting the minor across a state line to receive an abortion. Finally, the bill makes it a crime for a physician to knowingly perform or induce an abortion on an out-of-state minor without first notifying the minor's parent.

Stopping Overdoses of Fentanyl Analogues Act This bill adds five fentanyl analogues and the entire category of fentanyl-related substances to schedule I of the Controlled Substances Act. A schedule I controlled substance is a drug, substance, or chemical that has a high potential for abuse; has no currently accepted medical value; and is subject to regulatory controls and administrative, civil, and criminal penalties under the Controlled Substances Act.

Exit Tax Prevention Act of 2021 This bill prohibits a state, or taxing jurisdiction in the state, from imposing an income tax, wealth tax, or any similar tax on a resident who has relocated permanent residence to another state or taxing jurisdiction.

Prohibiting IRS Financial Surveillance Act This bill prohibits the Department of the Treasury from requiring a financial institution to report the transfers into and out of a financial account. This prohibition does not apply to laws or regulations in effect on October 1, 2021.

Accountability in Foreign Animal Research Act This bill prohibits the National Institutes of Health from conducting or supporting research that involves testing on vertebrate animals in China, Cuba, Iran, North Korea, Russia, or other countries determined to be a foreign adversary.