The Trump Administration’s proposed fiscal year (FY) 2020 budget includes extensive health-policy provisions.

Medicare, Value-Based, and Related Reforms

The Administration estimates that its Medicare policy reforms would save approximately $811 billion over 10 years. The Administration states that these proposals are “designed to improve value-based systems of care, exercise fiscal integrity, promote competition, reduce provider burdens, improve the appeals system, and address high drug prices.” Budget provisions that would result in significant Medicare savings include the following (savings are over the 10-year period of FYs 2020-2029): 

Other legislative proposals intended to promote value-based care that are not expected to have a budget impact include the following:

A number of the budget proposals are intended to reduce the burden that Medicare program rules impose on providers and suppliers. For instance, the budget calls forsimplifying the Merit-based Incentive Payment System and Advanced APM rules for physicians; authorizing the Centers for Medicare & Medicaid Services (CMS) not to impose the requirement for a face-to-face provider visit for all DME ordersand aligning the End Stage Renal Disease Quality Incentive Program with CMS’s Meaningful Measures initiative. Other planned Medicare administrative proposals, which do not require Congressional approval and which are not expected to have a budget impact, include:

The budget includes a reference to adding ventilators and certain orthotics to the next round of the DMEPOS competitive bidding program, which is estimated to save $6.1 billion over 10 years.

Program Integrity Proposals

The budget also features program integrity legislative proposals that the Administration estimates would save $19.6 billion over 10 years, in addition to a number of related regulatory proposals.

The Administration’s budget proposal covers many other HHS policies, such as Medicaid updates, Medicare appeals system improvements; medical liability reforms; changes to survey and certification policies; Medicare/Medicaid dually eligible beneficiary policies; and provisions to address the opioid epidemic. Congressional committees have begun holding oversight hearings on the HHS budget proposals. Additional consideration of the President’s recommendations, along with alternative health policy proposals, can be expected throughout the FY 2020 budget cycle.

Read the budget repot here: Fiscal year (FY) 2020 budget

Read the HHS brief here: Budget Brief

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