President Trump issued an executive order on October 3, 2019 as an alternative to “Medicare for All”. Initially, the order was titled “Protecting Medicare From Socialist Destruction” but was changed to “Protecting and Improving Medicare for Our Nation’s Seniors.”

The executive order does include some items that the Medical Association of the State of Alabama supports; however, there are concerns that the language within the order appears to expand the scope of practice of non-physician providers.

President Trump directed the Secretary of Health and Human Services, Alex Azar, to propose a new regulation within the next year that would “eliminate burdensome regulatory billing requirements, conditions of participation, supervision requirements, benefit definitions, and all other licensure requirements […] that are more stringent than applicable federal or state laws require and that limit professionals from practicing at the top of their profession.”

Possibly the most alarming language found within the order is that President Trump gave Azar only one year to propose regulations that would “ensure that items and services provided by clinicians, including physicians, physician assistants, and nurse practitioners are appropriately reimbursed in accordance with work performed rather than the clinician’s occupation.”

Mark Jackson, the Executive Director of the Medical Association, believes the language within the order should raise serious concerns for physicians in Alabama. “We believe that medical school matters and physicians should always be the head of the healthcare team,” Jackson says. ”Our mission is to promote the highest quality of healthcare for the people of Alabama. Therefore, we fully support physician-led team-based care and will be co-signing a letter with the American Medical Association as well as working closely with our Congressional Delegation to address our concerns.”

View the letter here.