3 key health policies in the Senate's $1T infrastructure package

The Senate is poised to pass a roughly $1 trillion bipartisan infrastructure package that will delay until 2026 a controversial Part D rebate rule.

While most of the new funding in the package, the text for which was released Sunday, goes toward infrastructure projects such as new roads or information technology, there are several healthcare-related provisions that could impact the industry.

Here are some of the healthcare items included:

Resuming Medicare sequester cuts

Providers got a win in the package when lawmakers agreed to not raid unallocated COVID-19 Provider Relief Fund monies. However, the legislation does deal a blow to the industry’s efforts to halt a 2% cut to Medicare payments from resuming.

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The cuts were created under sequestration in 2013. Congress decided to pause the cuts last year at the onset of the pandemic to help providers struggling financially. The moratorium on the cuts though ends after this year.

Major provider groups have implored Congress to not resume the cuts to help pay for infrastructure. The American Hospital Association wrote to congressional leaders last month saying that “providers cannot sustain additional cuts to the Medicare program;”

Requiring drugmakers to refund Medicare for any discarded drugs

The requirement applies to drugs dispensed under Medicare Part B, which reimburses for drugs administered in a doctor’s office such as chemotherapy. The requirement applies to single-dose containers or single-use package drugs.

Each quarter starting in 2023 the manufacturer must provide a refund for any single-use or single-dose products that were discarded that period; and

Requiring more domestic production of equipment

The pandemic exposed debilitating gaps in the supply chain for medical goods that include personal protective equipment. Manufacturing of PPE was based primarily overseas and companies experienced long delays right as demand accelerated with the onset of the pandemic.

The legislation demands that any federal contract to buy PPE must be for two years and go to a domestic manufacturer. The two-year time frame will give the domestic PPE maker enough financial security to stay in the market.

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The Senate is expected to vote this week on the package. It will then consider a $3.5 trillion package that could clear the chamber via a procedural move called reconciliation that ensures budget bills can pass via a simple majority and bypass the 60 votes needed to break a filibuster.

Democrats have sought to add more healthcare related provisions in the $3.5 trillion package, including adding dental, vision and hearing benefits to Medicare.

Sen. Ron Wyden, D-Oregon, told Fierce Healthcare last week that he is working to add drug pricing provisions into the package, including giving Medicare the authority to negotiate for lower prices.