On June 24, 2019, President Donald Trump issued an “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First” (the Order). The Order requires multiple federal agencies to issue regulations and take other actions as part of an ongoing focus of the Trump Administration to “enhance the ability of patients to choose the healthcare that is best for them” through transparency and competition. The Order addresses the following five initiatives.
1. Informing Patients About Prices
- The Department of Health and Human Services (HHS) must, within 60 days of the Order, propose regulations that require hospitals to publicly post standard charge information. This charge information must also include negotiated rates for common services.
- HHS, together with the Departments of Treasury (USDT) and Labor (DOL), must solicit comments on requiring providers, insurance carriers and group health plans to give notice to patients about their out of pocket costs before receiving care.
- HHS, the Attorney General, and the Federal Trade Commission (FTC) must, within 180 days of the Order, issue a report describing how the Federal Government or the private sector is impeding healthcare transparency, and why low cost providers avoid advertising.
2. Establishing a Health Quality Roadmap
Within 180 days of the Order, HHS, the Secretary of Defense (DOD) and the Veterans Administration (VA) must establish a Health Quality Roadmap on how to increase reporting of quality measures in Medicare, Medicaid and other federal healthcare programs. The Health Quality Roadmap must also include recommendations for publishing uniform quality, inpatient, and outpatient measures; and how to eliminate counterproductive measures.
3. Increasing Access to Data
HHS must, within 180 days of the Order, increase access to de-identified claims data from taxpayer-funded healthcare programs for “researchers, innovators, providers, and entrepreneurs.”
4. Easing Patients’ Healthcare-Related Tax Burden
Within 120 days of the Order, USDT must issue guidance expanding patients’ ability to select high-deductible plans and increasing the amounts that patients can carry over at the end of a year for flexible spending arrangements. The Order also directs USDT to propose regulations to allow direct primary care arrangements and other arrangements to be deemed tax-deductible medical expenses.
5. Address Surprise Medical Billing
HHS must, within 180 days of the Order, submit a report to the President with recommendations on addressing surprise medical bills (read the President’s past remarks on surprise medical billing here).
All health care providers will have to continue to monitor these agency actions as they are likely to have a significant effect on the healthcare industry. This order serves as another example of the Trump Administration’s attempts to address healthcare quality and cost concerns through increasing provider competition.
This post was co-authored by Michael Lisitano, legal intern at Robinson+Cole. Michael is not yet admitted to practice law.