Cut 2 regulations for every new 1: How Trump's latest executive order may affect healthcare

President Donald Trump issued an executive order Monday aimed at eliminating two federal regulations for every new one — an order that has the potential to significantly cut or confuse healthcare regulation.

The order also requires the costs of any new regulations to be offset by the two that are cut. "For fiscal year 2017, which is in progress, the heads of all agencies are directed that the total incremental cost of all new regulations, including repealed regulations, to be finalized this year shall be no greater than zero unless otherwise required by law or consistent with advice provided in writing by the Director of the Office of Management and Budget," the executive order reads.

The directive gives room for interpretation, particularly by President Trump's nominee for OMB director, Rep. Mick Mulvaney, R-S.C., who has yet to be confirmed. Once confirmed, the director of the OMB will have the flexibility to determine how and when the executive order is carried out, meaning it may or may not apply to healthcare regulations. "This vests tremendous power and responsibility in the OMB director to ensure the president's direction in how we manage this across the government," a White House official said, according to Reuters.

The order could have a significant effect on healthcare regulations set to roll out this year, including those under the 21st Century Cures Act and the Medicare Access and CHIP Reauthorization Act's Quality Payment Program. For example, the 21st Century Cures Act includes a number of new regulations aimed at speeding processes in the Food and Drug Administration, such as one that builds on the agency's current review process for medical devices, according to a report from STAT.

The order could be further complicated because some regulations are technically deregulations, STAT reports. This may be the case for MACRA, which aims to streamline several CMS programs into one. Quality reporting under MACRA is set to begin in 2017 to determine physician Medicare payments in 2019.

The order for deregulation has been meet with open arms by the American Hospital Association. "We are encouraged by the executive order signed by President Trump today that will help reduce red tape," AHA CEO Rick Pollack said in a statement. "Reducing the administrative complexity of healthcare would allow providers to spend more time on patients, not paperwork. In the past year alone, the federal government added 23,531 pages to the stack of existing regulations affecting hospitals and health systems."

 

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