On Jan. 20, the Trump Administration issued a memo to the heads of all executive departments and agencies freezing new and pending federal regulatory activity until the President’s appointees or designees have had the opportunity to review any new, recently finalized or pending regulations. The memo, which is common for an incoming administration, addresses regulations that have been sent to the Office of the Federal Register but not yet published, as well as regulations that have been published in the Federal Register but were not yet effective on Jan. 20.
The memo instructs federal agencies to withdraw any regulation not yet published for review and approval by the Trump Administration. In addition, it temporarily postpones the effective date of any regulations that were not yet in effect by Jan. 20 for at least 60 days following the issuance of the memo, subject to review and approval by Trump appointees.
Following review for substantial questions of law or policy, the memo directs the department or agency head to either take no further action and allow the rule to become effective, or notify the director of the Office of Management and Budget (OMB) to consult on the appropriate action. Final regulations relevant for hospitals that have been published but have effective dates later than Jan. 20 include:
- The Use of New or Increased Pass-Through Payments in Medicaid Managed Care Delivery Systems
- Confidentiality of Substance Abuse Disorder Patient Records
- Episode Payment Models for AMI, CABG and SHFFT
- Conditions of Participation for Home Health Agencies
- Updates to Medicare Claims Appeals Process
- Control of Communicable Diseases
- Federal Policy for the Protection of Human Subjects
- Implementation of Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items and Publication of the Initial Required Prior Authorization List of DMEPOS Items That Require Prior Authorization as a Condition of Payment
- Conditions for Coverage for End-Stage Renal Disease Facilities-Third Party Payment
- Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Other Provisions Related to Eligibility and Enrollment for Medicaid and CHIP
The memo excludes regulatory actions that are subject to statutory or judicial deadlines, address emergency situations or other urgent circumstances relating to health, safety, financial or national security matters and instructs the agencies to identify such regulations for the OMB director as soon as possible. CHA is currently monitoring all administrative activity on these matters and will advise the membership of any substantive deadline changes through CHA News. It is important to note that, if the administration chooses to delay implementation beyond 60 days, it would be required to proceed through notice and comment.