Executive Order on Transparency, HSAs: What Employers Need to Know 

Female nurse checks patient's vital signs, medical Mercer
Jun 27 2019

This week President Trump issued an Executive Order (EO) focused on increasing price and quality transparency, empowering consumers and managing cost. Here are a few highlights we think are of most interest to employers.

Let’s start with something employers have been asking for and expecting for a while. Treasury has been asked to issue guidance by the end of the year that will allow HSA-eligible health plans to cover low-cost preventive care, before the deductible, for medical care that helps maintain health status for individuals with chronic conditions.

The EO addresses price transparency and consumer protections from surprise medical bills first by directing HHS to propose rules (by August 23) that will require hospitals to disclose their negotiated rates in easy-to-understand, consumer-friendly format, and secondly by directing DOL, HHS and Treasury to propose rules (b  September 22) to require healthcare providers and health plans to provide expected out-of-pocket costs before patients receive care.

The EO also supports a theme included in congressional legislation by directing agencies to develop a plan (by December 21) to create a database containing de-identified claims data from taxpayer-funded healthcare programs and group health plans for researchers, innovators, providers, and entrepreneurs. And there is a directive for relevant agencies to develop a "comprehensive roadmap" (by October 22) setting forth consistent quality metrics needed to improve care.

Providers and health plans are objecting to aspects of the price transparency directive. There are many powerful lobbying groups that influence lawmakers and regulators in Washington DC. But given that employers currently manage and pay for the health care benefits for over half of the American people – 181 million of them – it’s important to be aware of these proposals and have your voice heard. The American Benefits Council and the ERISA Industry Committee do a great job or representing plan sponsors’ interests on these issues, as do other groups.

In anticipation of questions about the timing, it’s important to remember that the EO is essentially a list of health care actions directed to various departments within the Administration to act on from a regulatory perspective. The department or agency must develop draft regulations (sometimes with other departments/agencies) and release them to the public for comments by the given deadlines. After the comment period closes, the agency reviews all the comments, develops and releases final regulations. It does take a little time. As an example, the final HRA rules we wrote about last week were driven by an EO the President issued last year. This new round is just getting started – but we will keep you updated.

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