Home Health & Hospice Week

A new executive order signed by President Trump could bring you some regulatory relief — or it could make your life harder by encouraging Medicare Advantage utilization and cutting fee for service rates. Broad language included in the “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors,” which Trump signed on Oct. 3, could mean any number of things.

For example: In Section 10 of the order, the president says “within 1 year of the date of this order, the [HHS] Secretary shall propose regulatory changes to the Medicare program to reduce the burden on providers and eliminate regulations that create inefficiencies or otherwise undermine patient outcomes.” That could be good news, especially since the Trump administration has moved forward on certain regulatory relief initiatives in multiple areas.

However, the Centers for Medicare & Medicare Administration also has refused to budge on major regulatory burdens such as face-to-face physician encounter requirements, and has proposed new regulatory duties such as the Notice of Admission for home health agencies (see story, p. 289).

A more concerning push in the order is CMS’s plans to encourage more Medicare Advantage utilization. A forthcoming regulation on MA will “ensure that, to the extent permitted by law, FFS Medicare is not advantaged or promoted over MA with respect to its administration,” the order says.

That may hint at payment cuts to FFS providers, suggests the National Association for Home Care & Hospice in its member newsletter. “These references raise considerable concern given that providers who participate in FFS Medicare and contract with MA plans generally lose money on their MA patients,” NAHC worries. “Further, plans appear to be, as a general rule, reaping financial benefit from participation in the MA program.” A recent study shows that private insurers partici­pating in MA “enjoy an annual gross profit of more than $1,600 on each customer — double that of customers in the individual and group health plan market,” the trade group adds.

See the order at www.whitehouse.gov/presidential-actions/executive-order-protecting-improving-medicare-nations-seniors.