But when it comes to scrapping regulations, the Trump administration wants the healthcare sector to chime in.
“Overregulation stops American entrepreneurship, crushes small business, reduces consumer choice, discourages innovation and infringes on the liberties of American citizens,” Trump said in a news release on an executive order on deregulation he issued in January.
Some of the wish lists healthcare organizations are assembling for the administration are or will be publicly available, but much of these discussions are happening out of view and will stretch out over the coming months.
Trade associations already have offered insights into their goals via communications with the administration and publicly available documents or in response to requests for comment. Their aims include a mix of policies they have long supported with others inspired by the president's deregulatory agenda.
Deregulation agenda
The administration has offered up several opportunities to weigh in on regulations it should revoke. Most recently, CMS included a request for information in Medicare payment rules the agency proposed this month. Comments are due June 10.
CMS’s goal is to reduce duplicative policies, unnecessary regulations and overly burdensome requirements, which “can divert resources from patient care, contribute to inefficiencies and can create financial strain on providers,” CMS wrote on its website.
The White House Office of Management and Budget also issued a notice April 11 calling for deregulation opportunities, and gave the public until May 12 to submit recommendations.
An executive order Trump signed April 9 directs agencies to collaborate with the Justice Department and the Federal Trade Commission to identify "anticompetitive" regulations within 70 days.
There are also a handful of policies that are deregulatory in nature and are being carried out without the customary notice-and-comment opportunity that enables the public to know what the government is doing and provide feedback.
For example, an April 9 presidential memorandum directs agencies to begin cutting unnecessary regulations "without notice and comment, where doing so is consistent with the 'good cause' exception in the Administrative Procedure Act." Trump tasked agencies with compiling lists of regulations to cut in a Feb. 19 executive order, which gave agencies 60 days to aggregate “unconstitutional regulations and regulations that raise serious constitutional difficulties” or that are based on “unlawful delegations of legislative power.”
A Jan. 31 executive order requires agencies to cut 10 regulations for each new one proposed, although it may not apply to most of the rules CMS issues.
What healthcare providers want from Trump
Hospitals are asking CMS to relax the conditions of participation rules they must follow to receive Medicare reimbursements. So-called COPs were "put in place to protect the health and safety of patients, but some of these requirements have become obsolete as the health system has evolved,” America’s Essential Hospitals President and CEO Dr. Bruce Siegel wrote CMS April 14.
Quality reporting could be relaxed, Ashley Thompson, senior vice president of public policy analysis and development at the American Hospital Association, said in an interview. For example, CMS should scrap a sepsis measure and replace it with a measure that focuses on outcomes, she said.
Hospitals also want the administration to streamline price transparency requirements, which Trump has made a priority, Thompson said.
“The AHA supports price transparency and encourages the administration to streamline the multiple price transparency policies to ensure that there is a single 'source of truth' for patients when it comes to price transparency,” Thompson wrote in an email. “This would result in more accurate, accessible and actionable pricing information, and ensure the policies are implemented efficiently.”
Hospitals are also looking for CMS to make mandatory Medicare payments models voluntary, and Transforming Episode Accountability Model, or TEAM, in particular, Thompson said.
The AHA, America’s Essential Hospitals, which represents safety-net facilities, and the long-term care trade association LeadingAge also await CMS formally withdrawing a 2024 regulation to set staffing minimums for nursing homes, which a federal court struck down this month.
What health insurance companies want from Trump
The Coalition Against Surprise Medical Billing, which includes the health insurance trade group AHIP and the Blue Cross Blue Shield Association, wants CMS to make the No Surprises Act out-of-network billing dispute resolution process more favorable to their members, it wrote the White House, HHS, the Treasury Department and the Labor Department last Tuesday.
The Alliance of Community Health Plans, which represents insurers affiliated with nonprofit health systems, wants CMS to nix a variety of quality and performance reporting requirements, including for defunct programs such as the Medicare Advantage Value-Based Insurance Design model, which CMS shut down last year.
The association also wants CMS to ease rules regarding beneficiary communications, such as requiring them to opt into digital communications. These mandates are the "epitome of administrative burdens,” Alliance of Community Health Plans President and CEO Ceci Connelly wrote to CMS April 9.
