The administration has issued an executive order directing the Department of Health and Human Services (HHS) to alter the Medicare Advantage (MA) program, increase cost and quality transparency, and continue site-neutral payment policies.
In the executive order, the administration stresses the importance of building on the current Medicare program and criticizes Medicare for All approaches that it says would eliminate choices for beneficiaries. A large portion of the executive order focused on MA. including:
- adjusting network adequacy requirements in MA;
- aligning Medicare fee-for-service payments with MA payments; and
- encouraging innovative MA benefit structures and plan designs.
In the broader Medicare context, the executive order directs the HHS secretary to:
- issue a regulation to eliminate “burdensome regulatory billing requirements, conditions of participation…,” and other requirements that are stricter than applicable federal or state laws;
- ensure that Medicare site-neutral payment and policies focus on offering patients care in a diversity of sites;
- propose a regulation to provide seniors with better quality care and cost data;
- eliminate fraud, waste, and abuse in the Medicare program; and
- make regulatory changes to reduce burden on providers and eliminate regulations that undermine patient outcomes.
The next step will be for HHS to act on the administration’s directives in the executive order through regulatory and subregulatory actions. America’s Essential Hospitals will continue to track these issues of importance to our members.
Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.
