President Donald Trump signed an executive order on Thursday that aims to improve Medicare by giving seniors access to more innovative, affordable plan options.
The order, titled Protecting and Improving Medicare for our Nation's Seniors, directs HHS to propose regulations and implement administrative actions that encourage Medicare Advantage plans, in particular, to offer innovative plan designs and benefits including telehealth services and supplemental benefits not available in the traditional fee-for-service Medicare program.
The order directs the agency to create a new payment model that adjusts Medicare Advantage supplemental benefits to allow seniors to more directly share in any cost savings that Advantage plans generate, including monetary rebates. The administration ordered HHS to reduce barriers that limit adoption of Medicare medical savings accounts, which are a type of Advantage plan featuring a high-deductible attached to a tax-free savings account that few seniors have enrolled in today.
Trump also charged HHS with ensuring that the traditional Medicare program is not promoted or does not receive any advantages over privatized Medicare Advantage. It directs the agency to find ways to modify Medicare fee-for-service payments to more closely reflect the prices paid for services in Medicare Advantage and the commercial insurance market and encourage more competition.
"The executive order commissions us to examine all practices, regulations and guidance to just make sure that we are not steering people into fee-for-service as opposed to giving them a genuine choice of Medicare Advantage or fee-for-service," HHS Secretary Alex Azar said in a media call Thursday morning ahead of the executive order.
Trump signed the order at a retirement community in Florida. Much of the order is focused on condemning Medicare for All proposals, which Trump told supporters during his speech Thursday would "totally obliterate" Medicare. He promised to strengthen the Medicare program and give seniors more choice and control over their benefits. He said the executive order is the latest step in the administration's mission to drive better healthcare for Americans.
The executive order also directs HHS to adjust Medicare Advantage plan network adequacy requirements to factor in access to telehealth services as well as market competition, including whether the states maintain certificate-of-need laws or other restrictions.
The order charges HHS with proposing a regulation to eliminate regulatory requirements that prevent medical professionals from practicing at the top of their licenses and ensure services provided by physicians and other practitioners are "appropriately reimbursed in accordance with the work performed rather than the clinician's occupation."
Allowing nurse practitioners and medical assistants to practice at the top of their license would "really enhance access to care, enhance provider availability for all Medicare beneficiaries, including in fee-for-service, and really help, especially with the rural healthcare crisis," Azar said in the media call.
The order also aims to encourage innovation in medical devices and telehealth services by streamlining their approval, coverage and coding process so they are brought to market faster. To that end, it directs HHS to adopt regulations and guidance that cut the time and steps between approval by the Food and Drug Administration and coverage decisions by the CMS.
Other sections of the order aim to encourage site-neutral payments, provide seniors with healthcare cost and quality data, and eliminate Medicare waste and fraud.