Rep. Abigail Davis Spanberger

Maddy summaryThis bill changes Medicare coverage for colorectal cancer screenings. It eliminates out-of-pocket coinsurance costs for these screenings starting in 2026, requiring Medicare to cover 100% of the cost instead of the previous 85% for that year. The change applies to all subsequent years and directly affects Medicare beneficiaries seeking routine colorectal cancer screenings. The key provision amends Medicare Part B to remove the coinsurance requirement for these specific preventive services.

Maddy summaryHR 3387, the No Surprise Bills for New Moms Act, requires health insurance plans and employers to automatically cover newborns for 30 days after birth for any services the plan normally covers, without requiring prior enrollment. This directly affects new parents (including fathers) and their newborns, preventing unexpected bills during the initial post-birth period. The bill also mandates a 60-day special enrollment period to formally add the baby to the plan and requires insurers to notify parents immediately if a claim is filed for an unenrolled newborn. These provisions apply to both employer-sponsored and private health insurance plans.

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 Preventing Illegal Weapons Trafficking Act of 2023 requires federal agencies to develop a strategy within 120 days to intercept machinegun conversion devices - parts designed to convert regular firearms into machineguns. The strategy must include better coordination between federal and local law enforcement, training for state and local police to identify these devices, and tracking their origins to identify trafficking patterns. It also amends tax law to allow forfeiture of proceeds from illegal machinegun trafficking and mandates that the Attorney General include specific data on machinegun conversion devices in the annual firearms trafficking report. This law directly affects federal agencies (like the ATF and DHS) and state/local law enforcement through new coordination, reporting, and data-collection requirements.

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 summaryThe PROTECT 340B Act of 2023 prohibits pharmacy benefit managers (PBMs), health insurance plans, and health insurance issuers from discriminating against healthcare providers participating in the 340B drug pricing program. It specifically bans these entities from paying less for 340B drugs than they would for similar drugs dispensed by non-340B providers, imposing special requirements on 340B providers, or requiring identification of 340B drugs in billing. The bill establishes civil penalties of up to $5,000 per violation per day for PBMs that violate these protections and requires the Health Resources and Services Administration to create implementing regulations. It directly affects safety-net hospitals, clinics, and health centers that serve low-income patients, particularly those in rural areas, by protecting their ability to use 340B drug discounts to provide affordable care.

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 would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.

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 summaryThe Affordable Insulin Now Act (HR 1488) requires health insurance plans and issuers to cover specific insulin products with cost-sharing capped at $35 per 30-day supply or 25% of the negotiated price, whichever is lower, starting in 2024. It directly affects people with diabetes who rely on insulin by limiting out-of-pocket costs for covered products. The bill mandates coverage of all insulin types (rapid-acting, long-acting, etc.) and dosage forms (vials, pumps, etc.) as selected by the plan. This applies to both group and individual health insurance plans under the Public Health Service Act, Internal Revenue Code, and ERISA, with cost-sharing counting toward annual deductibles.