Medicare Improvement (E.O. 13890)

Summary

Strengthens Medicare by giving seniors more private plan options, lowering costs through competition, and cutting down on rules for doctors.

What problem does this solve?

Some people want to replace Medicare with a single government-run system, which could take away choices for seniors and all Americans. This order aims to protect and improve the current Medicare system by adding more private plan options and using market competition to make it better.

What does this order do?

Increases Medicare plan choices

Directs the government to create rules that give seniors more diverse and affordable Medicare Advantage (MA) plans, including options with medical savings accounts and better telehealth benefits.

Reduces burdensome rules for doctors

Requires a review of Medicare rules to get rid of billing and supervision requirements that are stricter than state laws, allowing medical professionals to spend more time with patients.

Speeds up access to new medical technology

Streamlines the process for approving and covering new medical devices and technologies, so that innovative products can get to patients faster.

Fights Medicare fraud with new technology

Requires the use of new tools like artificial intelligence to find and stop fraud, waste, and abuse in the Medicare program, protecting both patients and taxpayers.

Changes how traditional Medicare pays for services

Requires a study on how to make payments in traditional Fee-for-Service (FFS) Medicare more like the prices paid by private Medicare Advantage plans to encourage competition.

Gives patients more cost and quality information

Directs the government to give seniors better data on healthcare quality and costs. This helps them make more informed decisions about their doctors and health plans.

Ensures fair pay for different types of clinicians

Requires a review of payment rules to make sure that clinicians like nurse practitioners and physician assistants are paid based on the work they do, not just their job title.

Who does this affect?

Seniors
Medicare beneficiaries
Healthcare providers

What is the real world impact?

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Strengthens the existing Medicare system

Protects the current Medicare program against proposals for a single government-run system. Focuses on improving the parts that work well, like the market-based Medicare Advantage plans, to give seniors more choices and better care.

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Promotes private insurance within Medicare

Encourages the growth of Medicare Advantage (MA), which is run by private insurance companies. This shifts Medicare away from the traditional government-paid model and toward a system that relies more on private market competition.

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Reduces government oversight in healthcare

Cuts down on federal rules that doctors and hospitals must follow. Critics might argue that while this reduces burdens on providers, it could also weaken protections that ensure patients receive high-quality care.

When does this start?

Sets several deadlines for reports and proposed rules, most of which are due within 180 days or one year from October 3, 2019.

Report on Medicare payment changes

Within 180 days, a report must be submitted on how to make traditional Medicare payments more like prices in the private market.

Study on market-based pricing

Within 180 days, a study must be completed on how to move traditional Medicare toward market-based pricing.

New rules for more plan choices

Within one year, new regulations must be proposed to give seniors more diverse and affordable Medicare plan options.

Reforms to reduce provider burden

Within one year, reforms must be proposed to get rid of burdensome regulations so doctors can spend more time with patients.

Changes to encourage innovation

Within one year, changes must be proposed to speed up the approval and coverage of new medical technologies.

Actions to combat fraud

By January 1, 2021, changes must be proposed to fight fraud, waste, and abuse in Medicare, with updates every year after.