Rep. Carol D. Miller

Maddy summaryThe Patients First Act of 2026 modifies how Medicare reimburses physicians and primary care providers to improve access and stabilize payments. It establishes a new hybrid payment model for primary care services from 2027 to 2031, which pays a monthly fee per patient to eligible independent practices while covering specific services like care management and telehealth without cost-sharing for patients. The bill also updates the formula for calculating reimbursement rates to account for high inflation years and requires more frequent updates to the costs used in calculating payments. Additionally, the legislation reforms the performance-based payment system by adding care efficiency measures, creating a task force to recommend new quality metrics, and adjusting penalties for providers who fail to report on certain data.

Maddy summaryThe Essential Caregivers Act of 2026 requires nursing homes, long-term care hospitals, rehabilitation facilities, and intermediate care facilities to allow two chosen family members or friends to visit residents during times when regular visitation is suspended. These essential caregivers must agree to follow the facility's existing safety and infection control rules, which are no more restrictive than those applied to staff. While facilities can limit access for the first seven days of a suspension or deny entry if a caregiver shows symptoms of a serious infectious disease, they cannot block visits for end-of-life care. Additionally, the bill mandates that complaints about denied access to essential caregivers be investigated and resolved within three days.

Maddy summaryThe Saving Today's Acute-Care Resources Act modifies how Medicare calculates payment rates for long-term care hospitals to ensure they receive appropriate funding for treating complex patients. Starting in fiscal year 2027, the bill expands the criteria for avoiding payment reductions by adding a "high acuity" standard that considers patients transferred from acute care or critical access hospitals with severe diagnoses. It also updates existing rules to include discharges from long-term care hospitals that have undergone significant construction projects or hold state certificates of need. These changes aim to adjust reimbursement levels based on the severity of patient conditions and the specific history of the hospital treating them.

Maddy summaryThis bill requires Medicare Advantage plans to implement electronic pre-approval systems for medical services by 2028 and meet transparency reporting standards starting in 2027. Plans must publicly report data on approval/denial rates, appeal outcomes, response times, and technology use for pre-approval requests, including details on how denials relate to clinical criteria. It establishes a 24-hour response timeframe for certain requests and mandates annual reviews of pre-approval requirements based on data and input from seniors and providers. The law directly affects Medicare Advantage plans, seniors enrolled in these plans, and healthcare providers who submit pre-approval requests. These changes aim to make the pre-approval process faster, more transparent, and more accountable for seniors seeking covered medical services.

Maddy summaryHR 3108, the RPM Access Act, increases Medicare reimbursement for remote patient monitoring (RPM) in rural areas by setting a minimum reimbursement floor of 100% for practice expenses and malpractice costs starting in 2026. It requires that RPM services include real-time physician availability to address health issues, use data systems compatible with electronic health records, and mandates providers to report data on cost savings and adherence to medications. The bill directly affects rural Medicare beneficiaries with chronic conditions like heart failure and diabetes, as well as healthcare providers delivering RPM services in underserved rural communities. It also requires a 5-year report to Congress analyzing cost savings from RPM use, including reduced hospitalizations and medication adherence. The law aims to improve access to RPM in rural areas where healthcare shortages are most severe.

Maddy summaryThis resolution expresses support for designating July 10th as Journeyman Lineworkers Recognition Day to honor the workers who maintain the nation's electrical grid. The bill specifically recognizes the dangerous conditions these employees face, such as working at heights near live power lines and responding to disasters like hurricanes and wildfires. It also commemorates Henry Miller, the first president of the International Brotherhood of Electrical Workers, who died on July 10, 1896, while performing his duties. Ultimately, the measure encourages the public to observe this day with reflection on the contributions of lineworkers.

Maddy summaryThe SECURE 340B Act strengthens oversight of the drug discount program for safety-net health care providers by establishing clearer definitions for patients and prescribing providers, requiring detailed record-keeping to prove a legitimate patient relationship. The bill introduces strict rules for contract pharmacies, mandating that manufacturers cannot restrict discounts based on their use and requiring full transparency on where these drugs are dispensed. It also expands eligibility for child sites of covered entities while imposing a new community need standard based on geographic vulnerability scores to prevent abuse. To improve program integrity, the legislation creates a centralized data clearinghouse to track claims and prevent duplicate discounts, while simultaneously prohibiting discriminatory practices by insurance companies and pharmacy benefit managers against covered entities. Finally, the Act authorizes new user fees and additional funding for the Health Resources and Services Administration to support expanded audits and enforcement activities.

Maddy summaryThe Residential Recovery for Seniors Act expands Medicare coverage to include three specific levels of residential treatment for substance use disorders: clinically managed low-intensity, clinically managed high-intensity, and medically managed services. To qualify for this coverage, facilities must meet strict standards regarding staffing, clinical assessments, and adherence to evidence-based criteria developed by recognized medical associations. The bill also establishes a new payment system that reimburses these facilities on a per-day basis, starting in fiscal year 2027, with rates initially set to cover 100% of their estimated costs.

Maddy summaryThe Methane Removal Research and Innovation Act of 2026 directs the Department of Energy to create a research initiative aimed at developing methods to remove methane from the atmosphere. This program will fund multidisciplinary teams to study various scientific approaches, including biological methods, chemical reactors, and new materials, while also assessing costs and social barriers. The initiative is authorized to receive $25 million annually from 2027 to 2031 and requires the Secretary of Energy to report progress and scientific findings to Congress every three years.

Maddy summaryThis bill redesignates the existing National Parks and Public Land Legacy Restoration Fund as the America's Legacy Restoration Fund to address deferred maintenance on federal lands. It directs revenue from recreation fees and a portion of energy development income into the fund, which must be used primarily for repairing critical infrastructure like roads, trails, and buildings managed by agencies such as the National Park Service and the Forest Service. The legislation establishes strict rules requiring that most funds go toward non-transportation projects, mandates transparency through public dashboards tracking project status, and sets aside a small percentage for matching private donations. Additionally, the bill increases entrance fees for foreign visitors to ensure they contribute to the fund, while prohibiting the use of these specific funds for land acquisition or employee bonuses.