Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors

November 5, 2019

On October 3, President Trump signed an Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors. The Order’s stated purpose is to protect Medicare “rather than upend it” via the proposed Medicare for All Act of 2019.

Among mandates such as requiring Medicare Advantage (MA) payment models that allow beneficiaries to share more directly in the savings from the program and improving patient access to care through network adequacy, the Order requires that Medicare Fee-for-Service is not advantaged over MA. Additionally, the administration orders that CMS does a comprehensive review of regulatory policies that create disparities in reimbursement between physicians and non-physician practitioners. The Order states that clinicians should be reimbursed “in accordance with the work performed rather than the clinician’s occupation.” The Order requires that all of its mandates are completed within one year.

On October 29, 2019, your Academy joined over 100 specialty societies and state medical associations in a coalition letter to the U.S. Department of Health & Human Services expressing concern with the provisions related to the supervision and reimbursement of nonphysician professionals. The letter emphasizes physician-led, team-based care and highlights the considerable difference in the education and training of physicians compared to other health care providers. The letter ultimately urges the Administration to refrain from pursuing this proposal. The full letter can be viewed here.