Healthcare is one of the most regulated industries in the U.S. economy, so President Donald Trump made a lot of healthcare leaders happy with his executive order calling for the federal government to kill two regulations with each new one it rolls out.
Fulfilling that promise will be complicated, if not totally unworkable—the order raises important questions that might not be answered until it's enforced in practice. It will be up to the Office of Management and Budget to standardize how regulatory costs are measured and clarify what qualifies as new and offsetting regulations—the agency already issued interim guidance for regulators on Friday that answers certain questions.
Nevertheless, trade groups representing stakeholders across the industry have long lists of requirements they'd love to see the administration erase.
Providers, payers and vendors do business under a complex and constantly changing array of rules drafted by several agencies and departments, including the CMS, the Health Resources and Services Administration, the Food and Drug Administration and the Office of the National Coordinator for Health Information Technology.
Almost all of them come with a cost, and Trump's order also calls for an annual cap on the economic burden of new rules. For the rest of fiscal 2017 the cap requires that the cost of additional regulations be completely offset by undoing existing rules.
Last year alone, according to the American Hospital Association, the federal government added 23,531 pages to the regulations affecting hospitals and health systems. “The regulatory burden that is imposed on hospitals and health systems is substantial and unsustainable, and has grown in recent years,” AHA CEO Rick Pollack said in a statement praising the order.
Among the major rules released last year were ones that mandated a medical loss ratio for Medicaid managed-care plans; banned discrimination at federally funded hospitals, physician practices and clinics; and clarified how physicians will be paid under the new value-based framework outlined in the Medicare Access and CHIP Reauthorization Act, known as MACRA.