Maddy summaryThis bill requires Medicare Advantage (MA) plans to maintain accurate, publicly accessible provider directories containing essential details like provider names, specialties, contact information, and accessibility features. MA organizations must verify directory accuracy quarterly (or annually for hospitals), remove outdated providers within 5 business days, and clearly flag outdated information. If a beneficiary relies on an incorrect directory listing for a non-participating provider, the MA plan must cover the same cost-sharing as if the provider were in-network. These requirements apply to all network-based MA plans starting in 2026, with annual accuracy reports and public score disclosures beginning in 2027.
Rep. Carol D. Miller
Sponsored bills
Maddy summaryThe Responsible Use of Seafloor Resources Act of 2024 directs the President to coordinate federal agencies in supporting U.S. development of seafloor nodule collection and domestic processing for critical minerals used in defense and clean energy. It mandates annual reports analyzing the environmental, social, and economic impacts of seafloor minerals compared to land-based mining, including job creation and ecosystem effects. The reports will assess how U.S. sourcing aligns with security goals and international standards, while tracking benefits like supply chain diversification and reduced reliance on foreign sources.
Maddy summaryThis bill requires Medicare to cover falls risk assessments and fall prevention services during annual wellness visits and initial preventive physical exams for seniors aged 65+ who have fallen in the previous year. It directly affects Medicare beneficiaries with recent falls and healthcare providers delivering these services under Medicare. The key mechanism expands existing Medicare benefits to include these specific fall prevention services, effective January 1, 2025. Additionally, it mandates annual reports starting in 2026 tracking falls data for seniors over 65 who received fall-related treatment.
Maddy summaryThe MATCH IT Act of 2024 establishes national standards to improve patient matching accuracy in electronic health records. It requires the Secretary to create a uniform definition for measuring patient match rates (accounting for duplicate/overlaid records) and develop a minimum data set to support 99.9% matching accuracy by healthcare systems. The bill mandates incorporating this data set into health IT certification requirements and Medicare interoperability programs within 18-24 months. It also creates a voluntary Medicare bonus for providers meeting 90% patient match rates, with anonymous reporting of accuracy data. This directly affects healthcare providers, health IT vendors, and Medicare participants by requiring standardized matching protocols to reduce medical errors and costs linked to misidentification.
Maddy summaryThis bill removes a requirement for ambulatory surgical centers participating in Medicare to report the COVID-19 vaccination status of their healthcare workers. Specifically, it directs the Secretary of Health and Human Services to revise Medicare regulations (42 CFR §§ 416.300-416.330) within 45 days of enactment to eliminate this reporting mandate. The change directly affects ambulatory surgical centers that receive Medicare funding, removing a specific administrative burden related to employee vaccination data. The bill focuses solely on modifying existing reporting rules, with no new funding or program requirements.
Maddy summaryThis bill changes the negotiation period for small-molecule drugs under the federal Drug Price Negotiation Program from 7 years to 11 years, matching the existing 11-year period for biologic drugs. It directly affects drug manufacturers participating in the program by extending the timeframe for price negotiations with the government. The amendment applies to all small-molecule drugs covered under the program, creating a uniform negotiation timeline for both drug types. The change takes effect as if included in the Inflation Reduction Act of 2022.
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 summaryThe EASE Act of 2024 requires the Centers for Medicare & Medicaid Services (CMS) to test a new model improving access to specialty health care for Medicare and Medicaid beneficiaries in rural or underserved areas. It mandates CMS to partner with selected provider networks - comprising at least 50 community health clinics, nonprofits with proven community health work, and commitment to research - to deliver specialty care via telehealth and remote technology, coordinated with patients’ primary care providers. This model directly affects Medicare Part A/B beneficiaries and Medicaid enrollees living in designated underserved regions. The bill establishes specific criteria for network selection and defines "eligible individuals" based on coverage type and geographic location.
Maddy summaryThis bill amends Medicare eligibility rules to explicitly include occupational therapy as a qualifying service for home health care. It changes the Social Security Act to state that beneficiaries need "occupational, or speech therapy" (instead of only "speech therapy") to qualify for home health services. This change directly affects Medicare beneficiaries requiring occupational therapy at home, expanding access to this specific care. The policy takes effect for services provided on or after January 1, 2025.
Maddy summaryHR 6790 establishes National Institutes of Health centers to advance research, early detection, and public awareness of rare kidney diseases, with a focus on rural and underserved communities. It mandates a federal study on genetic testing barriers, treatment patterns, and public awareness for rare kidney diseases affecting disproportionately impacted populations, including barriers to insurance coverage and access to specialists. The bill also funds nephrology training programs to increase specialists serving these communities and requires experiments to delay or prevent the need for dialysis and transplants. Total funding of $7 million is authorized for fiscal years 2024-2028 to support these research, education, and early intervention efforts.