Bipartisan Senate infrastructure deal will not touch COVID-19 relief funds but delays Part D rebate rule

A roughly $1 trillion bipartisan infrastructure package will not divert unspent COVID-19 relief funding, but does delay a major rebate rule, according to published reports.

A bipartisan group of senators announced an agreement on major pieces of the roughly $1 trillion infrastructure package. The deal will not touch COVID-19 provider relief funds to help pay for the package. However, in a major win for pharmacy benefit managers, it will delay a rule to get rid of the safe harbor for Part D rebates, according to a summary of the legislation reported by Politico.

Several provider groups pushed back fiercely against a proposal to use the remaining money in a $178 billion provider relief fund as a pay-for, saying that hospitals and other providers are still struggling financially due to the pandemic.

The American Hospital Association wrote to congressional leadership earlier this week highlighting that COVID-19 cases are surging again across the country.

The Biden administration previously told Fierce Healthcare that there is roughly $24 billion left in the fund, which was pivotal to help shore up major revenue shortfalls that occurred due to the pandemic.

But the infrastructure package does deal a major blow to the pharmaceutical industry by including another delay to a rule that removes the safe harbor for Part D rebates. The rule approved at the tail end of the Trump administration instead creates a new safe harbor for discounts offered at the point-of-sale.

Pharmacy benefit managers and insurers have been major opponents of the rule, saying that it will lead to premiums rising for seniors on Part D.

The Biden administration delayed the start date of the rule by one year until Jan. 1, 2023.

The summary does not detail how long of a delay for the rebate rule, which was already delayed from going into effect until 2023 but noted it will add $49 billion.

The Senate will vote to start debate on the package on Wednesday. Senate Majority Leader Chuck Schumer hinted on Tuesday that the chamber could remain in session through the weekend to pass the package and send it to the House.

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