Victoria Spartz

**Locating Every Disbursement in Government Expenditure Records Act or the LEDGER Act** This bill requires the Department of the Treasury to implement a system that tracks all outlays from each appropriation, receipt, or other fund account in the Treasury by each department, agency, office, or other establishment in the executive, legislative, or judicial branches of the federal government. The system must also track the period of availability of the amounts in the applicable appropriation, receipt, or other fund account.

**Medal of Sacrifice Act of 2025** This bill directs the President to issue a medal of sacrifice for eligible law enforcement officers and first responders who are killed in the line of duty. The bill also directs the President to establish a commission on the medal of sacrifice and appoint its members. The bill sets forth responsibilities of the commission, including to advise on the design of the medal and determine how the medal will be presented. Under the bill, eligible law enforcement officers and first responders include federal, state, local, tribal, or territorial law enforcement officers or first responders who are not subject to an official act of wrongdoing (e.g., a determination that the officer or first responder acted outside the scope of their duties or in a manner that was not in accordance with official policies or procedures). A law enforcement officer or first responder who is subject to an official act of wrongdoing is generally not eligible for the medal of sacrifice. However, in the case of such an officer or first responder, the bill requires the commission to investigate the circumstances surrounding the officer or first responder's cause of death and issue a final determination on their eligibility.

**Preventing Hospital Overbilling of Medicare Act** This bill repeals certain exceptions to site-neutral payments with respect to Medicare payments to an off-campus outpatient department of a health care provider. It also requires providers to use separate, unique health identifiers when submitting a claim to a health insurance issuer for services provided at an off-campus outpatient department.

**Restoring Rights of Physicians to Own Hospitals Act** This bill repeals provisions under the Stark law (i.e., the Physician Self-Referral Law) that require rural providers and physician-owned hospitals to meet certain additional criteria in order to be excepted under the Stark law. Specifically, the bill repeals provisions that require hospitals to meet the following criteria: * the hospital had physician ownership or investment and a Medicare provider agreement as of December 31, 2010; * the hospital does not expand the number of operating rooms, procedure rooms, or beds beyond the number in existence as of March 23, 2010, with limited exceptions; * the hospital discloses certain information regarding physician ownership and investments to patients, the public, and the Centers for Medicare & Medicaid Services; * the hospital does not offer certain financial opportunities, and the percentage of ownership or investments does not exceed that in effect as of March 23, 2010; * the hospital discloses certain information to patients relating to the availability of physicians and makes alternative arrangements when necessary; and * the hospital was not converted from an ambulatory surgical center on or after March 23, 2010.

**Empowering Patient Choice of Medical Care Act** This bill prohibits the Centers for Medicare & Medicaid Services from refusing to designate a service as a covered hospital outpatient service under Medicare based solely on its determination that the service can only be furnished in an inpatient setting.

**NICS Data Reporting Act** This bill requires the Department of Justice to report annually on the demographic data of persons who are determined to be ineligible to purchase a firearm based on a background check performed by the National Instant Criminal Background Check System.

**Voting Only Through English Act or the VOTE Act** This bill requires states to use English-only ballots to qualify for certain federal election funds. It also repeals a prohibition on English-only federal elections and eliminates language assistance provisions under the Voting Rights Act of 1965 (VRA). (The VRA requires some jurisdictions to provide materials such as ballots and registration information in English and in other covered languages for voters whose English proficiency is limited. The bill removes these requirements.) Specifically, the bill prohibits a state from receiving federal election administration funds if the state provides ballots for a federal election that include text in any language other than English.

**Unlocking our Domestic LNG Potential Act of 2025** This bill repeals certain restrictions on the import and export of natural gas under the Natural Gas Act, including requirements for Department of Energy (DOE) approval and related provisions that address free trade agreements. In addition, the bill grants the Federal Energy Regulatory Commission (FERC) the exclusive authority to approve or deny applications to authorize the siting, construction, expansion, or operation of facilities (e.g., liquefied natural gas terminals) to export natural gas to foreign countries or import natural gas from foreign countries. (Currently, DOE authorizes the export or import of natural gas, and FERC authorizes related facilities.) In determining whether to approve or deny an application, FERC must deem the exportation or importation of natural gas to be consistent with the public interest.