Rep. Lizzie Fletcher

Maddy summaryHR 2726, the Small Business Payment for Performance Act of 2023, requires U.S. government agencies to provide small businesses with interim partial payments when they unilaterally change construction contract terms. Specifically, it mandates that agencies pay at least 50% of the estimated additional costs requested by small businesses within the timeframe specified by the contract. The bill also requires small businesses to pass these interim payments to first-tier subcontractors and any lower-tier subcontractors who incurred increased costs due to the contract change. This law applies directly to small business concerns awarded federal construction contracts and takes effect by October 1, 2025, or the start of the next full fiscal year after enactment.

Maddy summaryThe Puppy Protection Act of 2023 sets new standards for businesses that sell dogs (dealers), directly affecting pet stores and breeders operating under the Animal Welfare Act. It requires specific housing with space allowances based on dog size (e.g., 12-30 square feet per dog), temperature control (45-85°F), clean food twice daily, and daily exercise or socialization with humans/dogs for at least 30 minutes. The bill also mandates annual veterinary exams including dental care, strict breeding limits (e.g., age restrictions, maximum 2 litters in 18 months), and efforts to place retired breeding dogs in homes instead of selling them to other breeders. Regulations must be finalized within 18 months of enactment.

Maddy summaryHR 2665 delays Medicaid payment reductions for safety net hospitals by two years, changing the effective date from 2024 to 2026 under Section 1923(f)(7)(A) of the Social Security Act. This bill directly affects hospitals that serve high numbers of low-income and uninsured patients, providing them with additional time before facing reduced federal Medicaid payments. The key mechanism is a technical amendment to existing law, postponing an already scheduled payment adjustment without altering funding levels or eligibility. As a procedural bill, it does not create new programs or change hospital requirements.

Maddy summaryThe Panama Canal Zone Veterans Act of 2023 creates a presumption that veterans who served in the Panama Canal Zone between 1958 and 1999 (or until the last military member left) and developed specific illnesses are automatically eligible for VA benefits without needing to prove a direct link between their service and the condition. It lists 16 illnesses, including prostate cancer, lung cancer, diabetes, Parkinson's disease, and several other cancers, as qualifying for this presumption due to presumed exposure to herbicides like Agent Orange during service. The VA will use regulations based on medical evidence to determine which illnesses qualify under this provision. This change directly affects veterans who served in the Panama Canal Zone during the covered period and later developed one of the listed conditions.

Maddy summaryHR 2584, the SAVE Act, creates a new federal criminal offense for assaulting or intimidating hospital employees while they're performing their duties, punishable by up to 10 years in prison, with enhanced penalties for using weapons, causing injury, or during public emergencies. The bill authorizes $25 million annually in federal grants to hospitals for violence prevention programs, including staff training, security technologies like panic buttons and video surveillance, and coordination with law enforcement. It defines "hospital" broadly to include various medical facilities such as long-term care hospitals, rehabilitation facilities, and critical access hospitals. The legislation directly affects hospital workers and medical facilities by establishing federal criminal penalties for violence against employees and providing funding to improve workplace safety. The law aims to address the rising problem of workplace violence against healthcare workers, which the bill states has increased since 2011.

Maddy summaryHR 2630, the Safe Step Act, requires group health plans and health insurance issuers to establish a clear, transparent process for patients or their doctors to request exceptions to medication step therapy protocols. These protocols typically force patients to try cheaper drugs first before covering more expensive alternatives. The bill mandates that plans must approve exceptions when prior treatments failed, delay would cause serious harm, a treatment is unsafe, or a patient is stable on a previously approved drug, with strict 72-hour (or 24-hour in emergencies) decision timelines. It also requires plans to publish the exception process online and limit documentation requests to only necessary medical information. This law directly affects health insurers, employers offering health plans, and patients using step therapy for prescription drugs.

Expanding Opportunities for Diverse Entrepreneurs Act This bill requires the Department of Transportation (DOT) Disadvantaged Business Enterprise (DBE) program and recipients of assistance from the program to analyze and report on the program. The DBE program seeks to offer small disadvantaged businesses (i.e., certified as owned and controlled by socially and economically disadvantaged individuals) a fair opportunity to compete for federally funded transportation contracts. The bill requires the DBE liaison officers to track and provide an analysis of all efforts to expand knowledge of services and opportunities available (e.g., minimum outreach, training, and online development support) to non-certified and certified DBEs to increase an enterprise's ability to compete for, and perform on, federally funded transportation contracts; DOT to publicly post online a searchable and exportable version of the Uniform Report of DBE Awards/ Commitments and Payments for each state; and DOT to submit an annual report to Congress on the DBE program.

Maddy summaryThe CALM Modernization Act of 2023 updates the law requiring consistent audio levels between TV commercials and programming to include video streaming services. It directs the Federal Communications Commission (FCC) to create a new rule within one year that prevents streaming services from making commercial audio louder than the surrounding video content, similar to existing TV requirements. The rule would take effect 180 days after publication but allows up to one year of delay for streaming services facing significant financial hardship. The bill also mandates a government report to evaluate the current law's effectiveness in moderating commercial loudness.

Maddy summaryThis bill authorizes $50 million annually from 2024 through 2029 for the Centers for Disease Control and Prevention (CDC) to conduct or support research on firearms safety and gun violence prevention. The funding is specifically for studies under the Public Health Service Act, adding to existing research budgets rather than replacing them. It directly affects CDC researchers and public health agencies by providing dedicated resources to study gun violence causes and prevention strategies. The bill creates no new regulations or requirements, only enabling research to inform future policy decisions.

Resident Physician Shortage Reduction Act of 2023 This bill increases the number of residency positions eligible for graduate medical education payments under Medicare for qualifying hospitals, including hospitals in rural areas and health professional shortage areas. Current law provides for an increase of up to 200 positions per fiscal year beginning in FY2023, with a total increase of 1,000 positions; each hospital may receive up to 25 additional positions. Current law also provides for an additional increase of up to 200 positions for FY2026, with at least 100 of these positions for psychiatry or related specialties; each hospital may receive up to 10 additional positions. The bill provides for an additional increase of 2,000 positions per fiscal year from FY2025-FY2031; during this period, each hospital may receive up to 75 additional positions in total under the bill and current law. Additionally, one-third of the positions that are made available under the bill must be allocated to hospitals that are already operating above applicable resident limits. The bill also requires the Government Accountability Office to report on strategies to increase the diversity of the health professional workforce, including with respect to representation from rural, low-income, and minority communities.