Michael Rulli

Firearm Access During Shutdowns Act

This bill requires various federal agencies to continue certain operations, functions, and services related to firearms during a government shutdown.

The bill applies to

• the Federal Bureau of Investigation's National Instant Criminal Background Check System, including the processing of background checks in support of the operations of the Directorate of Enforcement Programs and Services of the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF);

• the ATF's Directorate of Enforcement Programs and Services;

• the activities of the Department of Commerce's Bureau of Industry and Security relating to firearms and firearm-related products, including activities related to processing of applications for export licenses; and

• the activities of the Department of State's Directorate of Defense Trade Controls relating to firearms and firearm-related products, including activities related to processing of applications for export licenses.

Under the bill, (1) these operations, functions, and services are deemed to relate to an emergency involving the safety of human life or the protection of property; and (2) employees carrying out the operations, functions, and services are deemed to be excepted employees. (Under an exception in the Antideficiency Act, an employee whose duties involve the safety of human life or the protection of property may be required to work during a government shutdown. Employees who are required to work during a government shutdown because they fall under this or other exceptions are known as excepted employees.)

This bill repeals the authority for a Senator to bring a civil action against the federal government if an internet service provider or the Senate Sergeant at Arms (SAA) accessed or disclosed, or accesses or discloses, data from the Senator's office to provide to a federal agency without following prescribed notice requirements. The authority applies to a qualifying instance occurring on or after January 1, 2022.

The authority for the civil action was enacted in H.R. 5371, the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026, which was signed by the President on November 12, 2026. The relevant provision requires written notice from the internet service provider or the SAA to the Senate office upon receipt of any legal process seeking access or disclosure of covered data. A Senator affected by a federal violation of the provision may sue the federal government for the greater of $500,000 per violation or the actual damages, plus attorney's fees and related costs.

This bill limits the amount of coinsurance that may be assessed under Medicare for services performed in ambulatory surgical centers.

Specifically, if the applicable coinsurance amount exceeds the inpatient hospital deductible, the Centers for Medicare & Medicaid Services must reduce the coinsurance amount so that it is equal to the amount of the deductible and pay the difference to the service provider.

Seniors’ Access to Critical Medications Act of 2025

This bill temporarily expands flexibilities under the Stark law (i.e., the Physician Self-Referral Law) for certain physicians who dispense covered outpatient drugs under the Medicare prescription drug benefit at the physician's office location (e.g., through an integrated pharmacy). The Stark law generally prohibits physicians from referring patients to receive services that are payable under Medicare or Medicaid from entities in which the physician or an immediate family member has a financial relationship.

Specifically, the bill allows, from 2026-2030, physicians to dispense such drugs from the physician's office, including through in-person pickup by a caregiver or via mail, if (1) the physician prescribed the drug, (2) the beneficiary has an ongoing relationship with the physician, (3) the beneficiary had at least one face-to-face visit with the physician in the prior year, and (4) the physician bills for the drug. These requirements also apply to physicians within the same group practice.

The Government Accountability Office must report on pharmacies or pharmacy networks that dispense significantly more covered drugs under the Medicare prescription drug benefit after the bill's enactment, the extent to which such pharmacies and networks are owned by physicians or integrated into physician practices, and the common characteristics of these types of arrangements.

Physician Led and Rural Access to Quality Care Act

This bill expands flexibilities for physicians and physician-owned hospitals under the Stark law (i.e., the Physician Self-Referral Law).

The Stark law generally prohibits physicians from referring patients to receive services that are payable under Medicare or Medicaid from entities in which the physician or an immediate family member has a financial relationship. The bill allows physicians or their immediate family members to have financial interests in rural hospitals that are located more than 35 miles (or 15 miles in certain mountainous areas or areas with only secondary roads) from a hospital or critical access hospital.

The Stark law also generally prohibits physician-owned hospitals from expanding the number of operating rooms, procedure rooms, or beds beyond the number in existence as of March 23, 2010, in order to be excepted under the Stark law. The bill removes this restriction.

US-Kazakhstan Trade Modernization Act

This bill addresses trade between the United States and Kazakhstan.

Specifically, the bill authorizes the President to determine that Section 402 of the Trade Act of 1974 (commonly known as the Jackson-Vanik amendment) does not apply to Kazakhstan. The Jackson-Vanik amendment denies normal trade relations (NTR) status to some current and former nonmarket economy countries unless they comply with certain freedom-of-emigration requirements. Under a provision of this amendment, the President may extend NTR status to a country affected by the amendment by waiving the freedom-of-emigration requirements or determining that the country is not in violation of those requirements, subject to an annual review. Kazakhstan has received temporary NTR status since 1992.

Additionally, the bill authorizes the President to extend permanent NTR status to Kazakhstan.

This concurrent resolution denounces socialism and opposes the implementation of socialist policies in the United States.

Ensuring Community Access to Pharmacist Services Act

This bill provides for permanent coverage under Medicare of certain pharmacist services.

Specifically, the bill provides for permanent coverage of testing and treatment services provided by pharmacists relating to (1) COVID-19, influenza, respiratory syncytial virus (RSV), and streptococcal pharyngitis (strep throat); and (2) other public health needs in relation to a declared public health emergency. (Similar authorities were temporarily granted during the COVID-19 public health emergency.) Such services must be provided in accordance with the applicable state laws governing pharmacists' scope of practice.

Pay Our Border Patrol and Customs Agents Act

This bill provides FY2026 appropriations for the salaries and expenses of certain U.S. Customs and Border Protection (CBP) employees who are required to work during a lapse in appropriations (i.e., government shutdown) in FY2026.

Specifically, the bill provides appropriations to CBP for the salaries and expenses of agents of the U.S. Border Patrol and officers of the Office of Field Operations who are excepted from furlough (i.e., required to work) during a lapse in discretionary appropriations in FY2026.

Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act

This bill allows, beginning in 2028, for Medicare coverage and payment for multi-cancer early detection screening tests that are approved by the Food and Drug Administration and that are used to screen for cancer across many cancer types, if the Centers for Medicare & Medicaid Services determines such coverage is appropriate. Coverage is limited to those under a certain age (age 68 in 2028, increased by one year every year thereafter) and to one test every 11 months.