Summary
Infrastructure
President Joe Biden is slated to lay out the first part of his $3 trillion “Build Back Better” economic recovery plan, focusing on rebuilding the nation’s infrastructure, on Wednesday (March 30). The second part of Biden’s plan will focus on health care and child care reforms and will be released in the coming weeks, according to White House press secretary Jen Psaki. Democrats are expected to push for prescription drug pricing reforms included in the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3, 116th), such as requiring the Department of Health and Human Services (HHS) to negotiate prices for selected drugs, to fund the infrastructure package.
Biden’s infrastructure plan may resemble the $1.5 trillion Moving Forward Act (H.R. 2, 116th) passed by House Democrats last Congress. The package would provide $30 billion for health care infrastructure, including $10 billion set aside for the construction and modernization of hospitals and medical facilities. In addition, the package would provide over $100 billion to fund broadband-related programs. Biden’s plan may also include investments in public health infrastructure at the federal, state, and local levels, a new priority included in the $312 billion Leading Infrastructure for Tomorrow’s (LIFT) America Act (H.R. 1848), introduced by all House Energy and Commerce Democrats earlier this month. On health care and broadband, the LIFT America Act largely mirrors provisions in the Moving Forward Act.
President’s Budget
On Thursday (April 1), Biden is expected to unveil his fiscal year (FY) 2022 “skinny” budget, which will contain topline discretionary spending priorities, followed by the full budget in early May. Notably, under current law, discretionary spending beginning FY 2022 is not subject to statutory spending caps. The President’s budget is likely to shed light on Biden’s fiscal policy and spending priorities for his presidency.
Regulatory Update
The final rule for the 2022 Notice of Benefit and Payment Parameters remains under review at the Office of Management and Budget (OMB) and its release is expected imminently. The rule would serve to finalize the set of provisions left unfinalized by the Trump Administration in its partial final rule earlier this year, wherein a subset of the most controversial provisions was finalized. Provisions that were not finalized then – and which could be finalized in this iteration – include policies on risk adjustment, medical loss ratio, and pharmacy benefit manager transparency.
MedPAC
Later this week (April 1 and 2), Medicare Payment Advisory Commission (MedPAC) will convene to vote on draft recommendations for its June Report to Congress regarding the following:
- Replacing the value-based purchasing program for skilled nursing facilities with an alternative value incentive program;
- Streamlining alternative payment models at the Centers for Medicare and Medicaid Services (CMS);
- Rebalancing Medicare Advantage program payments;
- Revising Medicare’s indirect medical education payments;
- Changing Medicare vaccine coverage and payment; and
- Updating requirements for separately payable drugs.
MedPAC will also discuss the role of private equity and Medicare for a report requested by House Ways and Means Committee Chair Richard Neal (D-MA). Additionally, MedPAC will examine CMS’ recent changes to Medicare’s clinical laboratory fee schedule payment rates for a congressionally-mandated report.