Neal Dunn

The Patients Choice in Specialty Pharmacy Act prohibits health insurance plans and insurers from steering patients toward affiliated specialty pharmacies when filling prescriptions for complex or expensive medications. Specifically, the bill bans practices like charging higher copayments for non-affiliated pharmacies, offering financial incentives to use affiliated ones, or creating administrative delays for patients who use independent specialty pharmacies. The legislation also requires insurers to contract with any qualified, licensed specialty pharmacy willing to accept standard network terms and reimbursement rates, though they can still exclude pharmacies involved in fraud, abuse, or those excluded from Medicare. This bill applies to most group health plans and individual insurance coverage but exempts self-insured employer plans. The new rules take effect on January 1, 2029.

Improving Coordination and Access to Resources Equitably for Youth Act or the Improving CARE for Youth ActThis bill prohibits state Medicaid programs from denying coverage for primary care, substance use disorder, and mental health services that are furnished on the same day at the same office, clinic, or other outpatient facility (including via telehealth).

H.R. 8890, the Enhancing Clinical Laboratory Innovation and Access Act of 2026, reforms how laboratory-developed tests (LDTs) are regulated under the Clinical Laboratory Improvement Amendments by placing them under the Department of Health and Human Services rather than FDA oversight. The bill requires laboratories to demonstrate that their tests are analytically and clinically valid, either through internal evidence or third-party validation approved by the FDA, with compliance required within two years of enactment. Laboratories must register all tests in a centralized FDA database, submit detailed performance data, report serious errors within five days, and can only perform these tests within their own high-complexity laboratory or corporate organization with limited exceptions. The legislation also modernizes CLIA regulations by requiring the Secretary to establish new examination standards for molecular diagnostics within 180 days and mandates that the Centers for Medicare and Medicaid Services provide 90 days' advance notice of regulatory changes and conduct comprehensive reviews every five years. These changes affect all clinical laboratories offering developed tests and aim to balance innovation in diagnostic testing with appropriate safety and quality oversight.

The Timely Access to Coverage Decisions Act of 2026 sets strict deadlines for Medicare administrative contractors to review requests for local coverage determinations, which are decisions about whether Medicare will cover specific medical services in particular geographic areas. Under the bill, contractors must determine within 60 days whether a coverage request is complete or incomplete, and must issue a final decision on complete requests within one year. The legislation also establishes a formal public review process for new or substantially revised coverage determinations, requiring contractors to publish draft decisions, hold public meetings with expert panels, accept public comments for at least 30 days, and provide responses to all comments before finalizing coverage decisions. Additionally, the bill creates a mechanism allowing interested parties—including Medicare beneficiaries, healthcare providers, and patient advocacy groups—to request that the Secretary review final reconsideration decisions to ensure they are based on appropriate evidence and do not conflict with existing rules or regulations. The bill's requirements take effect 90 days after enactment, meaning the first coverage requests under the new timelines would be received approximately one year after the law is signed.

The FAIC Act changes how Medicare pays for certain cancer drugs administered in hospital outpatient settings. Under current rules, Medicare bundles payments for high-cost cancer treatments into payments for broader services, which can undervalue expensive drugs. This bill requires Medicare to make separate, direct payments for cancer drugs and biologics that cost $350 or more per day (starting in 2026), using pricing based on average sales prices or wholesale acquisition costs. The law applies to cancer drugs approved by the FDA since 2008 that don't already receive special pass-through payments, and it affects Medicare beneficiaries by potentially improving their access to newer cancer treatments. To maintain budget neutrality, the government will adjust other payment rates accordingly, and the cost threshold automatically increases each year with standard Medicare payment adjustments.

First Responder Network Authority Reauthorization Act of 2026This bill extends through FY2037 and modifies the management of the First Responder Network (FirstNet) Authority. (The FirstNet Authority oversees the development and operation of FirstNet, a nationwide, interoperable broadband network for first responders.) The bill also requires certain actions of the entity operating FirstNet. Currently, the FirstNet Authority is an independent agency within the National Telecommunications and Information Administration (NTIA). The bill removes the FirstNet Authority’s independent status and establishes an associate administrator in the NTIA to manage the FirstNet Authority’s operations. The FirstNet Authority’s actions must be subject to NTIA approval, with exceptions established by the NTIA. The FirstNet Authority’s Board must include at least five (currently, three) individuals who have served as public safety professionals.The entity contracted to develop and operate FirstNet (currently AT&T) must notify the FirstNet Authority within 30 minutes of any network outage and provide users with a network status tool to monitor outages. Every five years, such entity must submit to the NTIA for approval a business continuity and disaster recovery plan to ensure rapid restoration of the network following disaster-caused outages. Annual audits of the FirstNet Authority must include an evaluation of such entity’s performance.The NTIA must brief Congress annually regarding FirstNet and provide annual reports relating to cybersecurity and network adoption rates. Within seven years after the bill’s enactment, the Government Accountability Office must report on what action Congress should take regarding the termination of the FirstNet Authority in 2037.

This bill authorizes Congress to award a Congressional Gold Medal to Frank Siller in recognition of his work founding and leading the Tunnel to Towers Foundation. The foundation was created in honor of Siller's brother, firefighter Stephen Siller, who died in the September 11 attacks, and it has since provided mortgage relief to families of fallen first responders, built homes for injured veterans, and supported homeless veterans. The medal honors Siller's decades of advocacy for veterans, first responders, and 9/11 victims' families, including his 255-mile walk in 2021 commemorating the 20th anniversary of the attacks. The Treasury Department will design and strike the gold medal and may produce and sell duplicate bronze versions to recover costs, with any proceeds going back to the U.S. Mint. There is no separate funding mechanism specified beyond using existing U.S. Mint resources to cover production costs.

The Mental Health TALK SAFE Act modernizes federal rules for prescribing controlled substances through telehealth, primarily to expand mental health treatment access. The bill allows qualified psychiatrists and psychiatric nurse practitioners to prescribe certain mental health medications (non-narcotic Schedule II drugs and Schedule III-V drugs) after conducting just one telehealth evaluation with a patient, rather than requiring an in-person visit. It establishes detailed standards for telehealth entities—including requirements for full-time compliance officers, chief medical officers, and prohibitions on certain financial arrangements—to ensure quality and prevent abuse. The legislation also allows psychiatrists licensed in one state to practice telehealth in other states without obtaining additional state licenses, provided their primary state license and malpractice insurance apply. Additionally, pharmacists are prohibited from refusing to fill valid telehealth-prescribed controlled substance prescriptions without first attempting to validate the prescription, with violations subject to civil penalties up to $25,000. The law takes effect immediately upon enactment and overrides conflicting state laws.

This resolution expresses the House of Representatives' position that illicit fentanyl-related substances should be classified as weapons of mass destruction and endorses President Trump's executive order to that effect. The resolution highlights the severity of the fentanyl crisis, citing that a single kilogram can kill 500,000 people and that over 71,000 Americans died from synthetic opioid overdoses in 2021, making fentanyl the leading driver of the opioid epidemic. The resolution identifies China, Mexico, and India as major sources of illicit fentanyl and fentanyl precursors entering the United States. While this is a non-binding resolution expressing the House's sense rather than a law with specific funding or implementation timelines, it calls for the president to formally designate illicit fentanyl as a weapon of mass destruction and for Congress to place these substances permanently in Schedule I of the controlled substances list.

The Safe Messaging for Kids Act of 2025 aims to protect minors (anyone under 17) from online harms by restricting how social media platforms handle messaging with young users. The bill prohibits social media companies from offering "disappearing message" features to minors and requires them to provide parents with tools to control and monitor their child's direct messaging contacts. For children under 13, direct messaging will be disabled by default unless parents explicitly consent to enable it. App stores must also warn parents when their child attempts to download an app with direct messaging features. The Federal Trade Commission and state attorneys general will enforce the law, treating violations as unfair or deceptive business practices. Social media platforms have 180 days to comply with most provisions, with up to 18 months for full implementation, though the law explicitly protects encryption and does not require companies to weaken security measures.

Sickle Cell Disease Comprehensive Care ActThis bill allows state Medicaid programs to establish health homes to provide coordinated care for individuals with sickle-cell disease. (Under current law, state Medicaid programs may establish health homes to provide coordinated care for individuals with specified chronic conditions.) States must ensure that such care includes dental and vision services.The Centers for Medicare & Medicaid Services must issue best practices for states on how to design and implement such health homes.

The Treatment Continuity Act of 2025 amends federal law to expand treatment options for substance use disorders and serious mental illness by authorizing the Secretary of Health and Human Services to fund programs that provide long-acting injectable medications approved by the FDA, along with lab testing, counseling, and provider training. The legislation affects healthcare providers, treatment facilities, and patients struggling with addiction and mental health conditions by increasing access to these medications and supportive services. The bill requires the Secretary to submit annual reports to Congress starting one year after enactment documenting program outcomes and patient progress toward treatment goals. No specific funding amounts are outlined in the legislation; instead, it grants authority to distribute existing federal grants under the Public Health Service Act. The amendments apply to all grants distributed under this program after the law is enacted.

This bill streamlines the process for repairing or upgrading communications infrastructure (such as cell towers and broadband facilities) in areas hit by major disasters or emergencies declared by the President. Specifically, it exempts these communications projects from two federal review requirements: the National Environmental Policy Act (which typically requires environmental impact assessments) and the National Historic Preservation Act (which requires historical preservation reviews). The exemption applies to projects that replace damaged communications facilities or make improvements to help communities recover from disasters, as long as the work begins within five years of the presidential disaster declaration. The bill affects telecommunications companies and federal agencies involved in approving communications projects in disaster areas, allowing faster restoration of critical communication services while bypassing lengthy environmental and historical review processes.

This bill prohibits smoking on the premises of any Veterans Health Administration facility. The bill defines smoking as the use of cigarettes, cigars, and pipes (i.e., the heating or combustion of tobacco), as well as the use of any electronic nicotine delivery system.

Streamlined FEMA Cost Exemption ActThis bill reduces to two years the statute of limitations for the Federal Emergency Management Agency (FEMA) to recoup disaster funding. It also requires FEMA to establish a ratio of acceptable error in its grants payments and authorizes the waiver of certain recoupment and duplication of benefits requirements.The bill reduces from three years to two the time period (starting from the final report of project completion) during which FEMA may take action to recover emergency or disaster assistance FEMA has provided to a state, Indian tribal, or local government. Also, under current law, FEMA generally must reduce and recover improper payments (i.e., payments that should not have been made or were made in an incorrect amount) and maintain an error rate below 10%. The bill requires FEMA to establish its own acceptable error ratio for providing emergency or disaster assistance funds for eligible purposes. It also authorizes FEMA to waive recoupment of certain emergency or disaster assistance (e.g., Public Assistance funding) when the provided funds exceed the total cost of the relevant project by no more than 5%.Additionally, the bill reauthorizes the President to waive the prohibition on the duplication of benefits upon request from the governor of a state if the President determines certain criteria are met. In exercising such authority, the President may not determine that a loan is a duplication. This authority is not applicable to FEMA’s Individual Assistance program or Public Assistance for repair and replacement.

The Ensuring Lasting Smiles Act requires health insurance plans to cover diagnosis and treatment services for congenital anomalies and birth defects affecting the eyes, ears, teeth, mouth, or jaw, including reconstructive surgery, dental work, and follow-up care. The coverage applies to both group health plans and individual insurance policies and takes effect for plan years beginning January 1, 2026. Insurance companies can still charge standard copayments and deductibles comparable to other medical services, but cannot impose additional restrictions specific to birth defect treatment. By January 1, 2026, insurers must notify members about this new coverage. The bill excludes purely cosmetic surgery unrelated to treating an actual birth defect, and directs the Secretary of Health and Human Services to study provider network adequacy and patient costs by December 31, 2027, to ensure people can actually access these services.

This bill amends federal tax law to treat spaceports the same way airports are treated for purposes of issuing tax-exempt bonds. Spaceports—facilities used for spacecraft manufacturing, launch and reentry operations, and crew/cargo transfers—would become eligible to use tax-exempt bonds to finance construction and improvements, a benefit previously unavailable to the commercial space industry. The legislation defines what qualifies as a spaceport, allows private industrial facilities and manufacturing to be included, and permits the federal government to use spaceports without those bonds being considered federally guaranteed (which would otherwise disqualify them). The changes take effect immediately upon enactment and apply to all bonds issued after the bill becomes law. This measure aims to reduce financing costs for spaceport development and help the United States remain competitive in the growing commercial space sector.

FEMA Loan Interest Payment Relief ActThis bill requires the Federal Emergency Management Agency (FEMA) to reimburse a local government or electric cooperative for interest paid on a loan used for emergency or disaster-related activities later paid for by FEMA assistance. The bill provides for similar reimbursement of interest to states for projects that are pending obligation.The bill retroactively applies to interest incurred by a local government or electric cooperative in the nine years preceding enactment of the bill.FEMA must reimburse states for loan interest for emergency or disaster-related projects that are pending obligation on the date of the bill’s enactment. FEMA must publish procedures for such reimbursement within 30 days after the bill’s enactment and states must apply within 60 days after publication of the procedures.The interest that qualifies for reimbursement may not exceed the amount of interest that would have been paid if the loan's interest rate were equal to the most recent prime rate.

H.R. 2677, the 10th Amendment Restoration Act of 2025, creates a nine-member Constitutional Government Review Commission to examine federal agencies and recommend which ones should be eliminated if their authority is not explicitly granted by the Constitution. The Commission, chaired by a presidential appointee and including members nominated by congressional leaders, will operate for approximately five years, publishing annual findings and recommendations to guide Congress on agency reforms. To speed up implementation, the bill establishes expedited legislative procedures allowing the House 30 days to vote on Commission recommendations (by simple majority only) and the Senate 30 hours of debate before passage, with no amendments permitted and limited veto-override debate. The Commission will be funded up to $30 million and granted authority to hire staff, conduct public hearings, issue subpoenas, and access agency information as it reviews whether federal agencies operate within constitutional bounds. This bill reflects an effort to transfer authority back to states and reduce federal agency scope based on constitutional interpretation.

Block Organ Transplant Purchases from China Act of 2025 or the Block Act of 2025This bill prohibits Medicare, Medicaid, and private health insurers from covering organ transplants that occur in China or that involve organs that are not procured through the U.S. Organ Procurement and Transplantation Network.The bill also prohibits health care providers from performing such a transplant or related services, except for life-saving services that are necessary as a result of such a transplant. Violations are subject to criminal and civil penalties.

The Ending China's Unfair Advantage Act of 2025 would halt U.S. federal funding for two major international environmental treaties—the Montreal Protocol (which protects the ozone layer) and the UN Framework Convention on Climate Change—unless China's classification changes in those agreements. Specifically, the bill prevents U.S. funding until China is reclassified from a "developing country" to a "developed country" status under the Montreal Protocol and is added to the list of industrialized nations with greater climate obligations under the UN climate treaty. The bill affects U.S. contributions to these international environmental initiatives and their associated funds, effectively conditioning American participation on changes to how China is classified in these global frameworks. Congress would need to determine what the actual funding impacts would be, and the President would need to certify that the international parties have made these changes before any funds could be released. The bill targets what sponsors view as unfair advantages China receives under current international environmental agreements due to its developing country designation.

This bill requires the Food and Drug Administration (FDA) to inform generic drug applicants, upon request or during review, whether the drug is qualitatively and quantitatively the same as the listed brand-name drug (and if not, the reasons why). The FDA must also update or publish guidance on how it makes such determinations.

The REPAIR Act requires car manufacturers to give vehicle owners direct access to their car's data and repair information through the same channels available to authorized dealers, while prohibiting manufacturers from restricting independent repairs, mandating branded parts (except for safety recalls), or preventing owners from choosing their own repair shops and towing services. The law requires anyone accessing vehicle data to delete it within 72 hours of request and limits its use to repair purposes, though manufacturers may keep de-identified data for research. The Federal Trade Commission will enforce the law by investigating complaints from the public and issuing orders against violators within five months of a violation not being remedied, treating violations as unfair or deceptive business practices. A severability clause ensures that if any provision is ruled invalid by courts, the remaining law remains in effect.

Prostate-Specific Antigen Screening for High-risk Insured Men Act or the PSA Screening for HIM ActThis bill requires private health insurance plans to cover evidence-based, preventive care and screenings for prostate cancer that are not already covered under the recommendations of the U.S. Preventive Services Task Force for certain men.Specifically, plans must cover such care and screenings for men who are age 40 and over and are at high risk of developing prostate cancer (e.g., with a family history of prostrate cancer). Such coverage must be provided without imposing any cost-sharing requirement.

This joint resolution nullifies the Environmental Protection Agency rule titled Phasedown of Hydrofluorocarbons: Management of Certain Hydrofluorocarbons and Substitutes Under the American Innovation and Manufacturing Act of 2020 and published on October 11, 2024. The rule establishes an emission reduction and reclamation program for the management of hydrofluorocarbons, which are greenhouse gases. The rule also establishes alternative Resource Conservation and Recovery Act standards for certain ignitable spent refrigerants being recycled for reuse.