Wisconsin Chronic Renal Disease Program: Fill & Download for Free

There is not much of a health plan that can become a replacement for the Patient Protection and Affordable Care Act of 2010, AKA Obamacare. It is likely to leave with no health care plan, just a patchwork of some Executive Orders that may still be applicable without the supporting PPACA in place, and lot of directives that have little force of law.The PPACA has provision for adults up to 26 years to be included on a parent’s healthcare plan, there is protection from being refused claims based on pre-existing conditions, there is a lifetime and annual maximum on out-of-pocket expenses, there are some states that have availed themselves to expand access to Medicare, there are tax rebate subsidies to support low-paid workers access to commercial and comprehensive health insurance plans if an employer does not offer anything, and some standards for Health Insurers and Providers. Nothing negative in the package, except that it is complex. There are 906 pages of detailed provisions across a range of Health Care issues. https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdfTrump’s healthcare is a an ‘ask’ for Pharmaceutical Companies to lower drug prices, make available cheap and cut-down Insurance Plans, provide some guarantees for Medicaid recipients with a lowest -price drug option, and removed the individual mandate tax penalty, weakening the participation in health care insurance. What is called a ‘Plan’ is just a list of initiatives that do not all have the weight and validity as a provision in a law, and will have no obligation to be followed - in this 8-page summary: https://www.govinfo.gov/content/pkg/FR-2020-10-01/pdf/2020-21914.pdfAs a plan, it is bankrupt, like its author. It merely summarizes positions, and does not wrap up an approach to Healthcare for all Americans, except for the assumption that if you are poor, you can die, and if you are rich, and might need to have coverage, their are a range of options now for you. If you are old, there is some Federal Support from what you have already paid for in Medicaid contributions, but do not hold out that it would last if you are not already on it now. Better that you read and understand that the emperor has no clothes, hence he stormed out of the 60 minutes meeting with Leslie Stahl as he does not understand what a Political. Government, or Legislative plan should entail.An America-First Healthcare PlanSection 1. Purpose. Since January 20, 2017, my Administration has beencommitted to the goal of bringing great healthcare to the American peopleand putting patients first. To that end, my Administration has taken monumental steps to improve the efficiency and quality of healthcare in theUnited States.(a) My Administration has been committed to restoring choice and controlto the American patient.On December 22, 2017, I signed into law the repeal of the burdensomeindividual-mandate penalty, liberating millions of low-income Americansfrom a tax that penalized them for not purchasing health-insurance coveragethey did not want or could not afford. Through Executive Order 13813of October 12, 2017 (Promoting Healthcare Choice and Competition Acrossthe United States), my Administration has expanded coverage options formillions of Americans in several ways. My Administration increased theavailability of renewable short-term, limited-duration healthcare plans, providing options that are up to 60 percent cheaper than the least expensivealternatives under the Patient Protection and Affordable Care Act (ACA)and are projected to cover 500,000 individuals who would otherwise beuninsured. My Administration expanded health reimbursement arrangements,which have been projected by the Department of the Treasury to reach800,000 businesses and over 11 million employees and to expand coverageto more than 800,000 individuals who would otherwise be uninsured. MyAdministration also issued a rule to increase the availability of associationhealth plans for small businesses, which, upon implementation of the rule,are projected to cover up to 400,000 previously uninsured individuals foron average 30 percent less cost.As set forth in the Economic Report of the President (February 2020), myAdministration’s expansion of health savings accounts will further helpmillions of Americans pay for health expenditures by allowing them tosave more of their own money free from Federal taxation, and will especiallyhelp Americans with chronic conditions who now have more flexibilityto enroll in plans that fit their complicated care needs and can be pairedwith a tax-advantaged account.At the beginning of the current COVID–19 pandemic, my Administrationacted to dramatically increase the accessibility and availability of telehealthservices for Medicare beneficiaries, enabling millions of individuals to usethese services. Pursuant to Executive Order 13941 of August 3, 2020 (Improving Rural Health and Telehealth Access), the Secretary of Health and HumanServices will make permanent many of the new policies that improve theaccessibility and availability of telehealth services. In addition, pursuantto that order, the Secretary of Health and Human Services and the Secretaryof Agriculture will develop and implement a strategy to improve the physicaland communications healthcare infrastructure available to rural Americans.Through our State Relief and Empowerment Waivers, my Administrationhas given States additional health-insurance flexibility, which has expandedhealth-insurance coverage options for consumers and lowered costs for patients. These waivers allow States to move away from the ACA’s rigidVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00003 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62180 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documentsstructure and are estimated to have lowered premiums by approximately11 percent in Wisconsin, 20 percent in Minnesota, and 43 percent in Maryland. Due to actions my Administration took, like the State Relief andEmpowerment Waivers, after years of dwindling choices and escalatingprices, plan options for consumers increased and for 2019, for the firsttime ever, benchmark premiums actually decreased on Get 2020 health coverage. Health Insurance Marketplace. For2020, the average benchmark premium dropped by nearly 4 percent.After the prior Administration spent tens of billions of dollars creatingelectronic health records systems unable to accurately or effectively recordand communicate patient data, my Administration has paved the way fora new wave of innovation to allow patients to safely send their own medicalrecords to care providers of their choosing. My Patients over Paperworkinitiative has cut red tape for doctors and nurses so they can spend moretime with their patients, which the Centers for Medicare and MedicaidServices (CMS) within the Department of Health and Human Services (HHS)has estimated to save over 40 million hours of wasted time for providersand suppliers between 2017 and 2021.(b) My Administration has been ceaseless in its efforts to lower coststo make healthcare more affordable for American patients.Under my tenure, prescription drugs saw their largest annual price decreasein nearly half a century. For three consecutive years, we have approveda record number of generic drugs. The Council of Economic Advisers hasestimated that these approvals saved patients $26 billion in the first 18months of my Administration alone. As part of the Further ConsolidatedAppropriations Act, 2020, I signed into law the Creating and RestoringEqual Access to Equivalent Samples Act, which will pave the way foreven more generic drugs and is projected to save taxpayers $3.3 billionfrom 2019 to 2029.CMS has acted to offer Medicare beneficiaries prescription drug plans withthe option of insulin capped at $35 in out-of-pocket expenses for a 30-day supply. We are also reducing Government payments to overcharginghospitals participating in the 340B Drug Pricing Program by instead payingrates that more accurately reflect the hospitals’ acquisition costs, whichCMS estimated would save Medicare beneficiaries $320 million on copayments for drugs alone.As a result of Executive Order 13937 of July 24, 2020 (Access to AffordableLife-Saving Medications), low-income Americans who receive care from afederally qualified health center will have access to insulin and injectableepinephrine at prices lower than ever before. Under Executive Order 13938of July 24, 2020 (Increasing Drug Importation to Lower Prices for AmericanPatients), my Administration will be the first to complete a rulemakingto authorize the safe importation of certain lower-cost prescription drugsfrom Canada. Pursuant to Executive Order 13939 of July 24, 2020 (LoweringPrices for Patients by Eliminating Kickbacks to Middlemen), my Administration is taking action to eliminate wasteful payments to middlemen by passingdrug discounts through to patients at the pharmacy counter without increasing premiums for beneficiaries or cost to Federal taxpayers. And my Administration is taking action to ensure that Medicare patients receive the lowestprice that drug companies offer comparable foreign nations through ExecutiveOrder 13948 of September 13, 2020 (Lowering Drug Prices by Putting AmericaFirst).As part of the Further Consolidated Appropriations Act, 2020, I also signedinto law the repeal of the medical device tax, the annual fee on healthinsurance providers, and the ‘‘Cadillac’’ tax on certain employer-sponsoredhealth insurance, which threatened to dramatically increase the cost ofhealthcare for working families.My Administration is transforming the black-box hospital and insurancepricing systems to be transparent about price and quality. Regardless ofhealth-insurance coverage, two-thirds of adults in America still worry aboutthe threat of unexpected medical bills. This fear is the result of a systemVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00004 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORDFederal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents 62181under which individuals and employers are unable to see how insurancecompanies, pharmacy benefit managers, insurance brokers, and providersare or will be paid. One major culprit is the practice of ‘‘surprise billing,’’in which a patient receives unexpected bills at highly inflated prices fromproviders who are not part of the patient’s insurance network, even ifthe patient was treated at a hospital that was part of the patient’s network.Patients can receive these bills despite having no opportunity to selectaround an out-of-network provider in advance.On May 9, 2019, I announced four principles to guide congressional effortsto prohibit exorbitant bills resulting from patients’ accidentally or unknowingly receiving services from out-of-network physicians. Unfortunately, theCongress has failed to act, and patients remain vulnerable to surprise billing.In the absence of congressional action, my Administration has already takenstrong and decisive action to make healthcare prices more transparent. OnJune 24, 2019, I signed Executive Order 13877 (Improving Price and QualityTransparency in American Healthcare to Put Patients First), directing certainagencies—for the first time ever—to make sure patients have access to meaningful price and quality information prior to the delivery of care. BeginningJanuary 1, 2021, hospitals will be required to publish their real price forevery service, and publicly display in a consumer-friendly, easy-to-understand format the prices of at least 300 different common services that areable to be shopped for in advance.We have also taken some concrete steps to eliminate surprise out-of-networkbills. For example, on April 10, 2020, my Administration required providersto certify, as a condition of receiving supplemental COVID–19 funding,that they would not seek to collect out-of-pocket expenses from a patientfor treatment related to COVID–19 in an amount greater than what thepatient would have otherwise been required to pay for care by an innetwork provider. These initiatives have made important progress, althoughadditional efforts are necessary.Not all hospitals allow for surprise bills. But many do. Unfortunately, surprisebilling has become sufficiently pervasive that the fear of receiving a surprisebill may dissuade patients from seeking appropriate care. And researchsuggests a correlation between hospitals that frequently allow surprise billingand increases in hospital admissions and imaging procedures, putting patients at risk of receiving unnecessary services, which can lead to physicalharm and threatens the long-term financial sustainability of Medicare.Efforts to limit surprise billing and increase the number of providers participating in the same insurance network as the hospital in which they workwould correspondingly streamline the ability of patients to receive careand reduce time spent on billing disputes.On May 15, 2020, HHS released the Health Quality Roadmap to empowerpatients to make fully informed decisions about their healthcare by facilitating the availability of appropriate and meaningful price and quality information. These transformative actions will arm patients with the tools tobe active and effective shoppers for healthcare services, enabling them toidentify high-value providers and services, and ultimately place downwardpressure on prices.My Administration has cracked down on waste, fraud, and abuse that directvaluable taxpayer resources away from those who need them most. MyAdministration implemented a ‘‘site neutral’’ payment system between hospital outpatient departments and physicians’ offices, to ensure Medicarebeneficiaries are charged the same price for the same service regardlessof where it takes place, which CMS estimates will save them approximately$160 million in co-payments for 2020. We also changed the rules to enableGovernment watchdogs to proactively identify and stop perpetrators of fraudbefore money goes out the door.(c) My Administration has been dedicated to providing better care forall Americans.VerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00005 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62182 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential DocumentsThis includes a steadfast commitment to always protecting individuals withpre-existing conditions and ensuring they have access to the high-qualityhealthcare they deserve. No American should have to risk going withouthealth insurance based on a health history that he or she cannot change.In an attempt to justify the ACA, the previous Administration claimedthat, absent action by the Congress, up to 129 million (later updated to133 million) non-elderly people with what it described as pre-existing conditions were in danger of being denied health-insurance coverage. Accordingto the previous Administration, however, only 2.7 percent of such individualsactually gained access to health insurance through the ACA, given existinglaws and programs already in place to cover them. For example, the HealthInsurance Portability and Accountability Act of 1996 has long protectedindividuals with pre-existing conditions, including individuals covered bygroup health plans and individuals who had such coverage but lost it.The ACA produced multiple other failures. The average insurance premiumin the individual market more than doubled from 2013 to 2017, and thosewho have not received generous Federal subsidies have struggled to maintaincoverage. For those who have managed to maintain coverage, many haveexperienced a substantial rise in deductibles, limited choice of insurers,and limited provider networks that exclude their doctors and the facilitiesbest suited to care for them.Additionally, approximately 30 million Americans remain uninsured, notwithstanding the previous Administration’s promises that the ACA wouldaddress this intractable problem. On top of these disappointing results,Federal taxpayers and, unfortunately, future generations of American workers,have been left with an enormous bill. The ACA’s Medicaid expansion andsubsidies for the individual market are projected by the Congressional BudgetOffice to cost more than $1.8 trillion over the next decade.The ACA is neither the best nor the only way to ensure that Americanswho suffer from pre-existing conditions have access to health-insurancecoverage. I have agreed with the States challenging the ACA, who havewon in the Federal district court and court of appeals, that the ACA, asamended, exceeds the power of the Congress. The ACA was flawed fromits inception and should be struck down. However, access to health insurancedespite underlying health conditions should be maintained, even if theSupreme Court invalidates the unconstitutional, and largely harmful, ACA.My Administration has always been committed to ensuring that patientswith pre-existing conditions can obtain affordable healthcare, to loweringhealthcare costs, to improving quality of care, and to enabling individualsto choose the healthcare that meets their needs. For example, when theCOVID–19 pandemic hit, my Administration implemented a program toprovide any individual without health-insurance coverage access to necessaryCOVID–19-related testing and treatment.My commitment to improving care across our country expands vastly beyondthe rules governing health insurance. On July 10, 2019, I signed ExecutiveOrder 13879 (Advancing American Kidney Health) to improve care for thehundreds of thousands of Americans suffering from end-stage renal disease.Pursuant to that order, my Administration launched a program to encouragehome dialysis and promote transplants for patients, and expects to enrollapproximately 120,000 Medicare beneficiaries with end-stage renal diseasein the program. We also have removed financial barriers to living organdonation by adding additional financial support for living donors, suchas by reimbursing expenses for lost wages, child care, and elder care. HHS,together with the American Society of Nephrology, issued two phases ofawards through KidneyX’s Redesign Dialysis Price Competition to worktoward the creation of an artificial kidney.My Administration has taken unprecedented action to improve the qualityof and access to care for individuals with HIV, as part of our goal ofending the epidemic of HIV in the United States by 2030. HHS has awardedVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00006 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORDFederal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents 62183at least $226 million to expand access to HIV care, treatment, medication,and prevention services, focused on 48 counties, Washington, DC, and SanJuan, Puerto Rico, where more than 50 percent of new HIV diagnoses occurredin 2016 and 2017, as well as seven States with a substantial rural HIVrate. We secured a historic donation of a groundbreaking HIV preventivemedication that is available at no cost to eligible patients.My Administration has started a transformation in healthcare in rural America. This includes a new effort, pursuant to my directive in Executive Order13941, to support small hospitals and health clinics in rural communitiesin transitioning from volume-based Medicare and Medicaid reimbursement,which has failed rural communities that struggle with a lack of patientvolume, and toward value-based payment mechanisms that are tailored tomeet the needs of their communities. We updated Medicare payment policiesto address a problem in the program’s payment calculation that has historically disadvantaged rural hospitals, and released a Rural Action Plan toincorporate recommendations from experts and leaders across the FederalGovernment. We have also dedicated a special focus on improving careoffered through the Indian Health Service (IHS) within HHS, including bycreating the Office of Quality, implementing an increase in annual fundingfor IHS by $243 million from 2019 to 2020, and expanding nationwideIHS’s successful Alaska Community Health Aide Program.My Administration has additionally demonstrated an incredible dedicationto protecting and improving care for those most in need, including seniorcitizens, those with substance use disorders, and those to whom our Nationowes the greatest debt: our veterans.I have protected the viability of the Medicare program. For example, onFebruary 9, 2018, I signed into law the repeal of the Independent PaymentAdvisory Board, which would have been a group of unelected bureaucratscreated by the ACA, designed to be insulated from the will of America’selected leaders for the purpose of cutting the spending of this importantprogram. On October 3, 2019, I signed Executive Order 13890 (Protectingand Improving Medicare for Our Nation’s Seniors), to modernize the Medicareprogram and continue its viability. According to CMS estimates, seniorshave saved $2.65 billion in lower Medicare premiums under my Administration while benefiting from more choices. For example, the average monthlyMedicare Advantage premium has declined an estimated 28 percent since2017, and Medicare Advantage has included about 1,200 more plan optionssince 2018. New Medicare Advantage supplemental benefits have helpedseniors stay safe in their homes, improved respite care for caregivers, andprovided transportation, more in-home support services and assistance, andnon-opioid pain management alternatives like therapeutic massages. MedicarePart D premiums are at their lowest level in their history, with the averagebasic premium declining 13.5 percent since 2016.My Administration has directed unprecedented attention on the substanceuse disorder epidemic, with a focus on reducing overdose deaths fromprescription opioids and the deadly synthetic opioid fentanyl. On October24, 2018, I signed the Substance Use-Disorder Prevention that PromotesOpioid Recovery and Treatment for Patients and Communities Act, enablingthe expenditure of billions of dollars of funding for important programsto support prevention and recovery. My Administration has provided approximately $22.5 billion from 2017 to 2020 to address the opioid crisisand improve access to prevention, treatment, and recovery services. Wesaw a 34 percent decrease in total opioids dispensed monthly by pharmaciesbetween 2017 and 2019, an approximate increase of 64 percent in thenumber of Americans who receive medication-assisted treatment for opioiduse disorder since 2016, and a 484 percent increase in naloxone prescriptionssince 2017. Data show that drug overdose deaths fell nationwide for thefirst time in decades between 2017 and 2018, with many of the hardesthit States leading the way.VerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00007 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62184 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential DocumentsImproving care for our Nation’s veterans has been a priority since the beginning of my Administration. On June 6, 2018, I signed the VA MaintainingInternal Systems and Strengthening Integrated Outside Networks (MISSION)Act of 2018, which authorized billions of dollars to improve options forveterans to receive care outside of Department of Veterans Affairs (VA)healthcare providers. Since taking effect, the VA estimates that more than2.4 million veterans have benefited from more than 6.5 million referralsto the 725,000 private healthcare providers with which the VA is nowworking. On June 23, 2017, I signed the Department of Veterans AffairsAccountability and Whistleblower Protection Act of 2017 to hold our civilservants accountable for maintaining the best quality of care possible forour Nation’s veterans by giving the Secretary of Veterans Affairs more powerto discipline employees and shorten an appeals process that can last years.On March 5, 2019, I signed Executive Order 13861 (National Roadmapto Empower Veterans and End Suicide) to ensure that the Federal Governmentleads a collective effort to prevent suicide among our veterans.I have used scientific research to focus on areas most pressing for thehealth of Americans. On September 19, 2019, I signed Executive Order13887 (Modernizing Influenza Vaccines in the United States to PromoteNational Security and Public Health), recognizing the threat that pandemicinfluenza continues to represent and putting forward a plan to preparefor future influenza pandemics. To modernize influenza vaccines and promote national security and public health, HHS issued a 6-year, $226 millioncontract to retain and increase capacity to produce recombinant influenzavaccine domestically, and the National Institute of Allergy and InfectiousDiseases, part of the National Institutes of Health within HHS, initiatedthe Collaborative Influenza Vaccine Innovation Centers program.Investments my Administration has made in scientific research will helptackle some of our most pressing medical challenges and pay dividendsfor generations to come. This includes working to increase funding forAlzheimer’s disease research by billions of dollars since 2017 and a planto invest more than $500 million over the next decade to improve pediatriccancer research. On December 18, 2018, I signed the Sickle Cell Diseaseand Other Heritable Blood Disorders Research, Surveillance, Prevention,and Treatment Act of 2018 to provide support for research into sicklecell disease, which disproportionately impacts African Americans and Hispanics, and to authorize programs relating to sickle cell disease surveillance,prevention, and treatment.On May 30, 2018, I signed the Trickett Wendler, Frank Mongiello, JordanMcLinn, and Matthew Bellina Right to Try Act of 2017, which gives terminally ill patients the right to access certain treatments without being blockedby onerous Federal regulations.In response to the COVID–19 pandemic, my Administration launched Operation Warp Speed, a groundbreaking effort of the Federal Government toengage with the private sector to quickly develop and deliver safe andeffective vaccines, therapeutics, and diagnostics for COVID–19. On August6, 2020, I signed Executive Order 13944 (Combating Public Health Emergencies and Strengthening National Security by Ensuring Essential Medicines,Medical Countermeasures, and Critical Inputs Are Made in the United States),to protect Americans through reduced dependence on foreign manufacturersfor essential medicines and other items and to strengthen the Nation’s PublicHealth Industrial Base.Taken together, these extraordinary reforms constitute an ongoing effort toimprove American healthcare by putting patients first and delivering continuous innovation. And this effort will continue to succeed because of myAdministration’s commitment to delivering great healthcare with morechoices, better care, and lower costs for all Americans.Sec. 2. Policy. It has been and will continue to be the policy of the UnitedStates to give Americans seeking healthcare more choice, lower costs, andVerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00008 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORDFederal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents 62185better care and to ensure that Americans with pre-existing conditions canobtain the insurance of their choice at affordable rates.Sec. 3. Giving Americans More Choice in Healthcare. The Secretary of theTreasury, the Secretary of Labor, and the Secretary of Health and HumanServices shall maintain and build upon existing actions to expand accessto and options for affordable healthcare.Sec. 4. Lowering Healthcare Costs for Americans. (a) The Secretary of Healthand Human Services, in coordination with the Commissioner of Food andDrugs, shall maintain and build upon existing actions to expand accessto affordable medicines, including accelerating the approvals of new genericand biosimilar drugs and facilitating the safe importation of affordable prescription drugs from abroad.(b) The Secretary of the Treasury, the Secretary of Labor, and the Secretaryof Health and Human Services shall maintain and build upon existing actionsto ensure consumers have access to meaningful price and quality informationprior to the delivery of care.(i) Recognizing that both chambers of the Congress have made substantialprogress towards a solution to end surprise billing, the Secretary of Healthand Human Services shall work with the Congress to reach a legislativesolution by December 31, 2020.(ii) In the event a legislative solution is not reached by December 31,2020, the Secretary of Health and Human Services shall take administrativeaction to prevent a patient from receiving a bill for out-of-pocket expensesthat the patient could not have reasonably foreseen.(iii) Within 180 days of the date of this order, the Secretary of Healthand Human Services shall update the Medicare.gov: the official U.S. government site for Medicare Hospital Comparewebsite to inform beneficiaries of hospital billing quality, including:(A) whether the hospital is in compliance with the Hospital Price Transparency Final Rule, as amended (84 Fed. Reg. 65524), effective January1, 2021;(B) whether, upon discharge, the hospital provides patients with a receiptthat includes a list of itemized services received during a hospital stay;and(C) how often the hospital pursues legal action against patients, includingto garnish wages, to place a lien on a patient’s home, or to withdrawmoney from a patient’s income tax refund.(c) The Secretary of Health and Human Services, in coordination withthe Administrator of CMS, shall maintain and build upon existing actionsto reduce waste, fraud, and abuse in the healthcare system.Sec. 5. Providing Better Care to Americans. (a) The Secretary of Healthand Human Services and the Secretary of Veterans Affairs shall maintainand build upon existing actions to improve quality in the delivery of carefor veterans.(b) The Secretary of Health and Human Services shall continue to promotemedical innovations to find novel and improved treatments for COVID–19, Alzheimer’s disease, sickle cell disease, pediatric cancer, and other conditions threatening the well-being of Americans.Sec. 6. General Provisions. (a) Nothing in this order shall be construedto impair or otherwise affect:(i) the authority granted by law to an executive department or agency,or the head thereof; or(ii) the functions of the Director of the Office of Management and Budgetrelating to budgetary, administrative, or legislative proposals.(b) This order shall be implemented consistent with applicable law andsubject to the availability of appropriations.VerDate Sep<11>2014 21:36 Sep 30, 2020 Jkt 253001 PO 00000 Frm 00009 Fmt 4705 Sfmt 4790 E:\FR\FM\01OCE0.SGM 01OCE0jbell on DSKJLSW7X2PROD with EXECORD62186 Federal Register / Vol. 85, No. 191 / Thursday, October 1, 2020 / Presidential Documents(c) This order is not intended to, and does not, create any right or benefit,substantive or procedural, enforceable at law or in equity by any partyagainst the United States, its departments, agencies, or entities, its officers,employees, or agents, or any other person.