Friday, July 16, 2021 This Week's Dose Senate Democrats reach partisan agreement on human infrastructure package. Centers for Medicare and Medicaid Services (CMS) release proposed physician payment rule that addresses coverage for telemedicine services and reduces the conversion factor by 3.75%. Biden directs agencies to consider reforms to enhance competition. Congress Senate Democrats Announced $3.5 Trillion Human Infrastructure Package. Senate Majority Leader Chuck Schumer announced the package late Tuesday night, which represents Biden Administration priorities that Democrats will seek to push through using a second attempt at reconciliation. While Democrats have not yet released any legislative text or itemized breakdowns of how the $3.5 trillion will be spent, initial reports indicate that the package will expand Medicare benefits to cover dental, hearing and vision services and address the Medicaid coverage gap in non-expansion states. There are also likely to be numerous policies focused on the Administration’s climate priorities, including investments in clean energy and reducing carbon emissions, as well as funding for childcare, paid family leave and community college. The package is rumored to be paid for in part by tax and prescription drug pricing policies, including repeal of the Trump Era “rebate rule,” which sought limit the use of rebates offered by pharmacy benefit managers. These numbers mark the beginning of a potentially lengthy and strategically tenuous process where Democratic leaders will try to shepherd two significant spending packages on the thin majorities. Leader Schumer is pushing to get a bipartisan physical infrastructure package moving in the Senate next week, opening debate as early as Wednesday. Meanwhile, the House has begun the process of moving 12 appropriations bills ahead of the August recess. The House plans to pass a “minibus” with seven appropriations bills (including Labor, Health and Human Services) next week, which the Senate will also have to eventually consider, making for a crowded agenda heading into fall.