Trump officials move to ease doctor anti-fraud rules in modernization bid

The Trump administration on Wednesday announced proposed changes to ease regulations targeting fraud by doctors in what it says is an effort to remove barriers to some legitimate innovative payment arrangements.

The proposed rules would create certain exceptions to regulations around two laws, the Physician Self-Referral Law and the Federal Anti-Kickback Statute. Those laws are intended to prevent doctors from referring patients for services that would financially benefit them, or taking bribes to generate new business.

{mosads}But the administration argues those rules can sometimes have unintended consequences by blocking some legitimate payment arrangements as well.

The very technical changes in the new proposed rules would create exceptions that allow for “value-based” payment arrangements, which is where doctors get paid more if their patients get better results. Officials say there would still be rules against actual fraud.

Those new payment arrangements are viewed by members of both parties as an important step in modernizing the health system and saving money in the long term by taking away incentives for doctors to simply order many tests and procedures because they get paid for each one.

More broadly, the Trump administration is also trying to continue a drumbeat of health care announcements as it seeks to show progress on an issue that Democrats used to great political advantage in the 2018 midterm elections. 

“Regulatory reform has been a key piece of President Trump’s agenda not just for faster innovation and economic growth, but also better, higher-value healthcare,” said Secretary of Health and Human Services Alex Azar. “Our proposed rules would be an unprecedented opportunity for providers to work together to deliver the kind of high-value, coordinated care that patients deserve.”