Rep. Kim Schrier

Maddy summaryThe HANDS Act requires Medicare, Medicaid, and TRICARE to cover naloxone (an opioid overdose reversal drug) with no out-of-pocket costs when distributed by hospitals to patients identified as at-risk for overdose. It applies to individuals receiving care in hospital emergency departments, inpatient settings, or ambulatory surgical centers, specifically at the time of discharge or when leaving the facility. The bill mandates that providers must determine a patient's overdose risk before distributing naloxone, along with administration instructions. This policy change eliminates cost-sharing barriers for this specific naloxone distribution method, aiming to increase access for vulnerable patients.

Maddy summaryThis bill requires Medicare Advantage (MA) plans to report detailed, individual-level data on supplemental benefits (like dental or vision coverage) starting in 2027. MA organizations must submit information on eligibility, benefit types, utilization, payments, and out-of-pocket costs per enrollee to the Centers for Medicare & Medicaid Services (CMS). Beginning in 2028, CMS will make this anonymized data publicly available annually via its website for research and program evaluation. The law aims to improve transparency around supplemental benefits, directly affecting MA plans and indirectly benefiting beneficiaries through better-informed program analysis. It includes strict privacy safeguards to protect individually identifiable information.

Maddy summaryThis bill simplifies participation in Medicare's Accountable Care Organization (ACO) program by removing distinctions between small and large ACOs and eliminating the requirement for new ACOs to assume financial risk for three years before joining shared savings models. It creates a new "100% shared savings" option where ACOs keep all savings from cost reductions but bear full financial responsibility for losses. The bill also mandates clearer, transparent benchmark calculations for ACO performance, establishes appeal processes for disputed benchmarks, and requires technical assistance for rural and underserved providers. These changes directly affect Medicare ACOs, particularly smaller or newer organizations in rural or safety-net settings, aiming to make value-based care participation more accessible.

Maddy summaryThe 9-8-8 Implementation Act of 2023 establishes a national mental health crisis response system centered around the 9-8-8 suicide prevention hotline. It provides $441 million for call center technology, staffing, and operations, and requires Medicare, Medicaid, and private health plans to cover crisis response services including mobile crisis teams and crisis stabilization facilities. The bill also mandates a national suicide prevention media campaign and creates protocols for 9-1-1 dispatchers to better respond to mental health crises. These provisions aim to improve access to mental health crisis care across the United States.

Maddy summary# Summary of the Farm Workforce Modernization Act of 2023 This comprehensive legislation introduces significant reforms to employment verification and immigration processes in the United States, with particular focus on agricultural workers. Key provisions include: ## Electronic Verification System (Section 301) - Establishes a new electronic verification system (replacing E-Verify) that must confirm identity and employment authorization within 3 business days - Includes photo matching tools, individual monitoring features, and fraud prevention measures - Requires employers to verify employment eligibility through this system ## Agricultural Industry Requirements (Section 302) - Mandates electronic verification for agricultural employers based on business size: * 500+ employees: 6 months after application period * 100-499 employees: 9 months after application period * 20-99 employees: 12 months after application period * 1-19 employees: 15 months after application period - Creates rural access points through USDA offices to assist with verification challenges ## System Modernization (Section 303) - Repeals the E-Verify Program and replaces it with the new verification system - Requires former E-Verify users to transition to the new system ## Compensation for Errors (Section 301) - Establishes an Electronic Verification Compensation Account to reimburse workers for lost wages due to government errors in verification - Includes procedures for contesting non-confirmations and appealing final nonconfirmations ## Additional Protections - Prohibits unfair immigration-related employment practices (e.g., terminating employees due to tentative nonconfirmations) - Creates a new compensation mechanism for workers wrongfully denied employment - Requires employers to provide specific notices to individuals with verification issues This legislation represents a major overhaul of employment verification processes, with special attention to agricultural workers and a focus on reducing errors that could lead to wrongful termination or denied employment. It also includes significant protections for workers against discrimination based on immigration status.

Maddy summaryHR 3842, the Expanding Access to Diabetes Self-Management Training Act of 2023, would improve Medicare coverage for diabetes self-management training (DSMT) services for beneficiaries with diabetes. The bill expands provider eligibility to include nonphysician practitioners (like nurse practitioners), increases available training hours (initial 10 hours plus up to 2 hours annually), and requires 100% Medicare coverage with no out-of-pocket costs for beneficiaries. It also mandates a new demonstration project starting in 2025 to test virtual DSMT services, evaluating impacts on health outcomes (like A1c levels), hospitalizations, and program costs. This legislation directly affects Medicare beneficiaries with diabetes and healthcare providers offering DSMT services.

Maddy summaryThe Menstrual Equity For All Act of 2023 requires free menstrual products to be available at no cost in public schools, colleges, correctional facilities, and federal buildings. It makes menstrual products covered by Medicaid, prohibits taxes on these products, and provides funding through social services programs to help low-income individuals access menstrual products. The bill directly affects students (K-12 and college), incarcerated people, homeless individuals, employees (in businesses with 100+ workers), Medicaid beneficiaries, and people receiving Temporary Assistance for Needy Families (TANF). Key provisions include amending school funding to require free products, creating college grant programs for menstrual product distribution, and adding menstrual products to Medicaid coverage and social services programs.

Maddy summaryHR 3561, the PATIENT Act of 2023, requires hospitals, health insurance plans, and pharmacy benefit managers to publicly disclose detailed pricing information for healthcare services and drugs. Hospitals must publish standard charges for 300+ shoppable services, including gross charges, payer-specific negotiated rates, and discounted cash prices, with updates required annually. Health plans must provide real-time information on in-network rates, cost sharing, deductibles, and prior authorization requirements for covered services. The bill establishes enforcement mechanisms, including civil monetary penalties for non-compliance, with fines ranging from $300 per day for small hospitals to $5 million for large hospitals that fail to comply with the transparency requirements.

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 changes tax rules to treat direct primary care (DPC) membership fees as deductible medical expenses. It defines DPC as a fixed monthly fee (capped at $150 per person, $300 for families) for primary care services only, excluding procedures requiring anesthesia, prescription drugs (except vaccines), or lab tests. The law ensures these fees can be claimed on tax returns like other medical costs, while clarifying DPC arrangements aren’t considered health insurance plans. It applies to fees paid for DPC services provided through employment or directly to patients, effective for 2024 tax years.