Rep. Diana Harshbarger

Maddy summaryHR 3282 requires Medicare Advantage plans and Part D prescription drug plans to disclose detailed financial and operational data about ownership relationships with providers and pharmacies. Starting in 2025, these plans must report information such as payment patterns, risk scores, rebate structures, and medical loss ratios for services provided by entities they own or control. The data, collected annually, will be made publicly available by 2027 in aggregated, non-identifying form to promote transparency. This affects Medicare Advantage organizations, Part D sponsors, and pharmacy benefit managers participating in Medicare.

Maddy summaryThis bill prohibits federal funding for gender transition procedures - including hormone therapy, puberty blockers, and surgeries like genital reassignment - across all federal programs and health plans. It exempts procedures for medical conditions (such as disorders of sex development) and treatment of complications arising from such procedures. The bill also blocks Affordable Care Act premium tax credits and cost-sharing reductions for health plans covering these services, though individuals may purchase separate non-federal-funded coverage. State and private insurers can still offer such coverage using their own funds, but federal subsidies cannot be applied to it.

Maddy summaryHR 3227, the Ensuring Seniors’ Access to Quality Care Act, amends Medicare and Medicaid rules to address nurse aide training programs in nursing facilities. It allows the Secretary of Health and Human Services to disapprove a facility’s nurse aide training program for up to two years if the facility received a $10,697+ civil penalty for substandard care and hasn’t corrected the quality issues. Facilities can have disapproval lifted by proving they fixed the care deficiencies, haven’t had recent patient harm incidents, and the penalty didn’t involve immediate patient jeopardy. The changes apply only to penalties assessed after the bill’s enactment and do not affect facilities already prohibited under prior rules.

Maddy summaryThis bill repeals the tax on Social Security benefits for seniors, making those benefits fully tax-free. It directly affects seniors who receive Social Security benefits and are currently subject to income tax on a portion of those payments. The key provision removes Section 86 of the tax code that previously included benefits in gross income, while a separate funding mechanism appropriates money to Social Security trust funds to replace the lost revenue. The bill ensures Social Security trust funds remain fully funded without requiring new tax increases.

Maddy summaryThis bill regulates pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans. It prohibits PBMs from earning income based on drug prices or rebates (requiring flat fees instead), mandates equal reimbursement for all network pharmacies, and requires PBMs to report how much of drug rebates they pass through to Medicare plans. The law also mandates annual compliance certifications and requires the government to publish aggregated transparency data (without revealing specific plan details) starting in 2024. These changes directly affect Medicare Part D plans and the seniors who rely on them for prescription drug coverage.

Maddy summaryThe Pharmacy Benefit Manager Sunshine and Accountability Act requires Pharmacy Benefit Managers (PBMs) to publicly disclose detailed financial information about their contracts with drug manufacturers and health plans. Specifically, PBMs must report total rebates received, administrative fees collected, amounts retained (not passed through to health plans), and the retained rebate percentage for each contract. This data, including the highest and lowest retained rebate percentages across all contracts, must be submitted annually to the Department of Health and Human Services and published on a public website. The bill directly affects PBMs and the health plans/insurance issuers they serve by increasing transparency in how drug pricing and rebates are managed.

Maddy summaryHR 2707, the MADE in America Act, creates a 25-30% federal tax credit for manufacturers producing specific health products (including drugs, medical devices, personal protective equipment, and diagnostic tools) in designated "distressed zones." These zones are census tracts with over 30% poverty rates that are also designated as qualified opportunity zones. The credit applies to wages paid to employees working in these zones and qualified production costs (like equipment and materials), increasing to 30% if most employees reside locally. It directly affects pharmaceutical and medical device manufacturers operating in eligible low-income areas, aiming to incentivize domestic production of critical health products.

Maddy summaryThis bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.

Maddy summaryHR 1610 would modernize Medicare coverage for chiropractic care by removing the current restriction that limited beneficiaries to one chiropractic service per visit. It expands coverage to include all services provided by licensed chiropractors within their state-authorized scope, aligning Medicare with VA, military, and private insurance practices. The bill requires chiropractors to complete a Secretary-approved educational webinar to cover non-spinal services, while still allowing payment for spinal manipulation treatments without this requirement. This directly affects Medicare beneficiaries seeking chiropractic care and chiropractors seeking Medicare reimbursement for their services.

Maddy summaryHR 1399, the "Protect Children's Innocence Act," prohibits medical gender-affirming care for minors under 18 by making it a class C felony for providers to perform such care. The bill defines gender-affirming care broadly to include surgical procedures, hormone treatments, and certain cosmetic procedures, with exceptions for medical conditions like reproductive cancers or intersex conditions. It prohibits federal funding for gender-affirming care through programs like Medicaid, Medicare, and the Affordable Care Act, and bans such care in federal health facilities. The bill also prevents institutions of higher education from teaching gender-affirming care and adds immigration consequences for individuals who provide such care to minors.