CMS Pauses Three Trump-Era Proposed Rules

CMS on Tuesday paused three proposed rules developed under the Trump administration.

The proposed rules would affect in-center dialysis coverage requirements for third-party payment programs, enable seniors to keep their Social Security retirement benefits if they opt out of Medicare Part A coverage and increase oversight of accrediting organizations. The White House budget office had been reviewing all three rules.

CMS withdrew the proposed rules following a memo last week from White House Chief of Staff Ron Klain directing agencies to freeze new regulations that hadn’t taken effect. The moves don’t take any of the policies off the table, but the Biden administration won’t sign off on any rules until it’s had a chance to review them. HHS froze a new regulation targeting community health centers’ 340B drug discounts last week.

The Obama administration signed off on an interim final rule forcing dialysis centers to inform their patients each year about all their public and private coverage options and third-party premium assistance. The rule also made dialysis centers tell health plans which individual market policies they were subsidizing.

The policy was meant to address concerns that some healthcare providers were steering patients into individual market coverage because it was in providers’ best interest. The rule took effect shortly before former President Donald Trump took office. An updated, permanent version of the regulation had been working its way through the rulemaking process but had been under review by the White House Office of Management and Budget since June 2019.

The Trump administration was also working on a proposal to allow seniors to collect Social Security retirement benefits if they chose not to accept Medicare coverage for inpatient services. Under the current rules, a person age 65 or older automatically applies for Part A coverage when they file to collect Social Security benefits.

The policy would have threatened “the universality of the program, which is vital to preserving its solvency and popularity,” according to the Kaiser Family Foundation. “Those most likely to opt out would likely be healthier and wealthier than average.”

OMB was reviewing a proposed rule from CMS in response to its request for information in December 2018 asking for feedback from accreditors like the Joint Commission regarding how they establish and disclose relationships with providers they both sell consulting services to and accredit for participation in Medicare. The proposed rule would recommend new requirements for accrediting organizations to conduct surveys.


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