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Trump Administration Issues Wide-Ranging Executive Order Impacting Healthcare

Trump Administration Issues Wide-Ranging Executive Order Impacting Healthcare
Posted on Friday, June 28, 2019 by Bruce Gillis

On Monday, June 24, the president issued an executive order aimed at improving healthcare price and quality transparency.


While the action has no impact on employers in the short term, it is significant for what it says about Trump’s direction for his administration to propose certain regulations. Once they are created, there will be a review and feedback process before any are finalized. Until that time, this order isn’t actionable, but employers would do well to keep the following details on their radars.

The executive order contains several directives ordering changes in several aspects of healthcare funding, pricing communication and data access. With the intent of expanding consumer price transparency and ability to shop for more cost-effective options, the order requires the following:

  • Within 60 days of the order,
    • HHS is to propose regulations to require hospitals to publicly post standard charge/rate information.
  • 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 expanding 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.
  • 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.

The order aligns with the GOP focus on account-based healthcare funding, directing updates to expand the use of HSAs and allowing increased year-over-year carryover within flexible spending accounts. Other directives target a desire to make healthcare delivery more “shoppable.” To achieve this, the administration is ordering the stakeholder agencies to define ways to provide price transparency, and out-of-pocket costs information pre-treatment, while also defining steps to address surprise medical billing. Lastly, HHS is also tasked with increasing access to de-identified claims data to improve research and innovation in healthcare delivery.

So, what does this mean? In the short term, we must wait to see how the respective agencies comply with this order, and what regulations are proposed. While some aspects of the order may receive bi-partisan support (such as the surprise medical billing review and price transparency), others will undoubtedly receive additional scrutiny. Efforts to increase access to claims data (even de-identified) will certainly have privacy watchdogs’ attention and increasing the account-based health plans approach may receive some push-back.

We’ll be watching these developing items closely, knowing they will create a lot of discussion and activity in months to come, and will keep everyone informed as more specifics emerge regarding the proposed regulations.

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