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Executive Order on Healthcare Price and Quality Transparency – Quick Look

Executive Order on Healthcare Price and Quality Transparency – Quick Look
Posted on Tuesday, September 3, 2019 by Bruce Gillis
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Most of you recall that several weeks ago, President Trump issued an executive order targeting various aspects of healthcare.

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I thought we would do a quick check-in on that list, which will help us set expectations on what other updates we should expect in the weeks and months to come.

On June 24, 2019, the Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First was issued, and it contained several mandates and required timelines. The order requires that:

  • Within 60 days of the order,
    • HHS is to propose regulations to require hospitals to publicly post standard charge/rate information.
      • UPDATE: On July 29, 2019, CMS proposed guidance to require hospitals to publish their negotiated rates, which effectively met the requirements set for within 60 days of the order.
    • Within 90 days of the order,
      • HHS, DOL and Treasury are to issue advance notice of proposed rule making requiring healthcare providers, insurance companies and self-insured group health plans to provide consumers with information about expected out-of-pocket costs for services.
    • Within 120 days of the order,
      • Treasury is to issue guidance expand the use of high deductible health plans that can be used with Health Savings Accounts (HSAs) and will provide low-cost preventive care before the deductible.
        • UPDATE: On July 17, 2019, the IRS issued Notice 2019-45, announcing a list of additional preventive care services and items for chronic conditions that may be treated as preventive care for purposes of Section 223 (c)(2)(c). This expands the list of preventive care benefits permitted to be provided by a high deductible health plan (HDHP), or with a deductible below the applicable minimum deductible (self-only or family) for an HDHP. This met the requirements of the order that would need to be completed within 120 days of the order.
      • Within 180 days of the order,
        • HHS, Defense, and the VA are to define a roadmap to improving data and quality measures across Medicare, Medicaid, CHIP, the Health Insurance Marketplace, the Military Health System, and the VA Health System.
        • HHS will increase access to de-identified claims data from taxpayer funded healthcare programs and group health plans for research and innovation.
        • Treasury will propose regulations to treat expenses related to certain types of arrangements, including direct primary care arrangements and healthcare sharing ministries, as eligible medical expenses under 213(d) of title 26 of the US Code.
        • Treasury will issue guidance increasing the amount of funds available for carryover at the end of the year for Flexible Spending Accounts (FSAs).
        • Treasury will report to the President on additional steps that can be taken to address surprise medical billing.

Since the executive order was issued on June 24, the Departments (HHS, DOL, and Treasury) would have until late September to comply with the order to propose guidance that requires health providers, plans and group health plans to provide expected out of cost information.

Additionally, those items mandated to be addressed within 180 days from the date of the order have almost until the end of the year—and none have been addressed yet. Surprise medical billing is shaping up to be a hot topic from the list—with healthcare companies taking out advertisements on TV and radio to voice their dissatisfaction with some of the suggested solutions, in an effort to shape the next steps.

The remainder of this year will likely hold a lot of additional healthcare guidance for employers to monitor —not to mention the ACA court case that is still being fought in federal appeals court. We will continue to watch each of these—providing updates as new developments surface. 

Want extra help with your compliance questions? 

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Bruce Gillis Head of Compliance Lorem ipsum dolor sit amet. View All Posts