On October 3, 2019, an Executive Order (“EO”) was signed that purported to “protect and improve” Medicare. Overall, the EO directs the Secretary and Department of Health and Human Services (“Secretary”) to propose changes that would move traditional Medicare towards a more market-based approach and promote Medicare Advantage (the alternative to traditional Medicare that is administered by private insurers). Most notably, the EO directs the Secretary to propose regulations that would make Medicare payments more closely reflect prices paid in the commercial insurance market.
The EO purports to accomplish various goals, some of which are highlighted below:
- Enable the Medicare program to provide beneficiaries with more diverse and affordable plan choices;
- Move Medicare to market-based payments, that would more closely reflect the prices paid for services under Medicare Advantage and the commercial insurance market;
- Change the Medicare billing structure to “enable providers to spend time with patients”;
- Streamline the process for innovative products, such as medical devices and telehealth services, to be covered by Medicare; and
- Eliminate waste, fraud, and abuse.
Since the EO only instructs the Secretary to propose changes, the specifics on how the EO will affect Medicare cannot be determined until the proposed regulations are released. These proposed regulations are expected within 1 year of the EO.
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