Rep. Charles J. "Chuck" Fleischmann

Maddy summary# Summary of Proposed Legislation This document outlines a comprehensive U.S. legislative proposal with several key components: 1. **Research Restrictions**: - Requires certification from Federal research grant recipients that they are not Chinese citizens or participants in Chinese talent programs - Prohibits employment of Chinese nationals in federally funded research - Requires institutions receiving Federal assistance to agree not to knowingly employ individuals participating in Chinese talent programs 2. **Foreign Gifts and Contracts Disclosure**: - Mandates disclosure of foreign gifts/contracts over $50,000 to universities - Requires public reporting of restricted/conditional gifts/contracts - Creates a searchable public database of foreign gifts to universities - Requires institutions to maintain policies regarding foreign gifts to faculty and staff 3. **Investment Restrictions**: - Restricts tax-exempt organizations from holding investments in "disqualified Chinese companies" (defined as corporations incorporated in China or with significant Chinese government ownership) - Requires annual reporting on such investments - Allows limited waivers with public disclosure 4. **Taiwan Policy**: - Prohibits U.S. government from recognizing PRC claims to sovereignty over Taiwan without Taiwan's consent - Requires U.S. government to treat Taiwan's democratically elected government as the legitimate representative of the people of Taiwan - Requires a strategy to protect U.S. businesses from Chinese coercion efforts 5. **Additional Provisions**: - Requires participants in Chinese talent programs to register as agents of the Chinese government - Amends economic espionage laws to include education and research - Mandates disclosure of certain funds received by visa holders The legislation represents a significant effort to limit Chinese influence in U.S. academic institutions, research, and business sectors while establishing a more robust policy framework regarding Taiwan.

Maddy summaryHR 7142 (Alternatives to PAIN Act) requires Medicare Part D plans to cover non-opioid pain management drugs with no deductible and at the lowest copay level starting in 2025. It defines "qualifying non-opioid drugs" as FDA-approved medications that don’t act on opioid receptors (like certain NSAIDs or nerve pain treatments), excluding opioids and schedule I-III drugs. The bill prohibits Medicare plans from forcing patients to try opioids first (step therapy) or requiring prior approval for these non-opioid options. It directly affects Medicare beneficiaries needing pain management, especially those seeking alternatives to opioids for post-surgical or acute pain. The policy change aims to improve access to non-addictive pain treatments while preserving doctors' authority to prescribe medically appropriate care.

Maddy summaryThis bill directs the Architect of the Capitol to create a time capsule for the U.S. Semiquincentennial (250th anniversary of independence). Congressional leadership will determine its contents, including representative materials about the Semiquincentennial, copies of key legislative milestones, and a message to future Congress. The capsule will be sealed on the Capitol's West Lawn by July 4, 2026, and remain unopened until July 4, 2276, when it will be presented to the 244th Congress for their consideration. The bill is procedural and does not affect citizens or change existing laws.

Maddy summaryThe Maximum Pressure Act (HR 6114) is a legislative proposal that would maintain and expand U.S. sanctions against Iran. The bill would codify existing sanctions, require Iran to meet 12 specific conditions before sanctions could be lifted (including ending support for terrorism, releasing hostages, and ending nuclear enrichment), and expand sanctions on Iran's Revolutionary Guard Corps and missile programs. It also establishes new reporting requirements for the U.S. government to monitor Iran's activities and the impact of sanctions. The legislation would require congressional review before any sanctions could be lifted or modified, preventing the executive branch from unilaterally easing restrictions.

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 establishes a minimum payment floor for Medicare reimbursements to rural hospitals not located in frontier states. It sets a 0.85 minimum for the area wage index used in hospital inpatient payments (starting October 2023) and a similar floor for outpatient department payments (starting January 2024). This prevents Medicare payments from dropping below 85% of the standard wage index for eligible rural hospitals. The bill includes budget neutrality requirements to ensure overall Medicare payments don't increase, while exempting hospitals already receiving payments above the floor.

Maddy summaryThe PASTEUR Act establishes a new subscription payment model to incentivize development of new antimicrobial drugs for resistant infections. It creates a Committee on Critical Need Antimicrobials and a Subscription Contract Office to manage payments based on specific drug characteristics like treating multi-drug resistant infections, novel mechanisms of action, and oral administration. Under this model, the government would pay drug developers up to $3 billion over 10 years for qualifying drugs, with payments tied to requirements like ensuring drug availability, reporting resistance data, and developing appropriate use plans. The bill aims to address the lack of new antimicrobial drugs by changing the funding model to reward drugs that meet specific clinical and public health needs.

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 summaryHR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.

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.