Update on Government Shutdown and Sequestration

As the government shutdown drags on the negative impacts continue to grow. If the shutdown continues through January 24, 2019, which is looking likely at this point, current law will require the Trump Administration to cut about $839 million from non-exempt federal benefit programs to avoid increasing the deficit. This is a result of the “PAYGO” (pay as you go) law which requires spending increases or tax cuts to be offset with cuts to programs or additional revenue to avoid increasing the deficit. As the largest nonexempt benefit program, it is likely that Medicare would experience the worst of these cuts through sequestration. While the Trump Administration has not yet issued a sequestration order, there is a distinct possibility that one could be issued if the shutdown continues much longer. A sequestration order would mean an additional across the board cut to all Medicare providers, including ambulance services. Ambulance service providers are still feeling the impact of the 2% sequestration cut that has been in effect the past few years. Any new cuts would likely start out being targeted at administrative tasks which could slow payments to providers. Temporary cuts would be expensive for the administration to facilitate and is...

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White House Memorandum on 2-for-1 Regulatory Order

On January 30, 2017, the Trump administration published Executive Order 13771 “Reducing Regulation and Controlling Regulatory Costs” which requires federal agencies to identify two rules for elimination for each new regulation issued. On April 5, 2017, the White House released a memorandum providing additional guidance on the implementation of Executive Order 13771. This memo supplements Office of Management and Budget (OMB) interim guidance issued on February 2, clarifies how agencies can comply with the order and explains which new regulations must be offset. The memo also notes that federal spending regulatory actions that cause only income transfers between taxpayers and beneficiaries (such as regulations associated with Medicare spending), and those that establish new fees or penalties without imposing any new costs, do not need to be offset. The AAA will continue to monitor this executive order and keep you informed. Read the full Memorandum...

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