President Trump signed an Executive Order, “Improving Rural Health and Telehealth Access” on August 3 to build on policies that Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma implemented in March at the beginning of the COVID-19 public health crisis.  Her easing of regulations under Section 1135 waivers of the Social Security Act improved access to healthcare, especially for Medicare beneficiaries, while keeping them safe.  The deregulatory efforts showed impressive results, with more than 135 new services and 43 percent of all Medicare primary care visits in April 2020 provided through telehealth.  It is another example of what happens when regulations are cut, and government control is reduced to improve healthcare.

An April 2020 Citizens Against Government Waste blog, “Telehealth is Here to Stay,” discussed various deregulatory measures that were implemented by CMS.  The 1135 waivers can be used by the Department of Health and Human Services (HHS) to act beyond normal activities when a disaster has been declared by the president.  The deregulatory measures implemented included paying providers to visit with their patients through telehealth, while easing privacy enforcement actions under HIPAA during the pandemic.

In a press briefing, President Trump said he was using the EO to make many of the regulatory reforms implemented for telehealth during the pandemic permanent, with a strong focus on improving rural healthcare.

The EO requires CMS to launch an innovative payment model to improve rural care.  The model would, “give rural providers flexibilities from existing Medicare rules, establish predictable financial payments, and encourage the movement into high-quality, value-based care.”

The EO would also require within 30 days for the Secretary of Agriculture (USDA) to coordinate with the Federal Communications Commission (FCC) to develop a strategy to upgrade, with the necessary investments, infrastructure for telecommunications for rural Americans to help improve and increase the use of telehealth and telemedicine.

The EO requires HHS within 30 days to submit a report on how to increase access to healthcare in rural areas by eliminating regulatory burdens.  The EO would also require developing rural-focused efforts to prevent disease and morbidity, with a focus on reducing maternal mortality and morbidity and improving mental health in these communities.

And within 60 days, the EO requires CMS to review and expand the temporary measures put in place during the public health emergency.  Through regulation, these initiatives would be extended beyond the pandemic wherever possible, like adding more telehealth services for Medicare beneficiaries and keeping the flexibilities initiated during the pandemic for delivering health services, staffing, and reporting requirements by Medicare providers.

CMS Administrator Seema Verma, FCC Chairman Ajit Pai, and USDA Secretary Sonny Perdue each commented on the importance of easing regulations and opening up telehealth to rural areas on a permanent basis.

The EO represents another positive step taken by President Trump to expand his deregulatory efforts, as opposed to proposals to increase government control in healthcare.  The EO will help improve and advance healthcare delivery in the U.S., especially in rural areas.