In a Sept. 11, 2019, file photo, Health and Human Services Secretary Alex Azar speaks with reporters outside of the White House in Washington. The Trump administration Wednesday, Oct. 9, proposed to overhaul decades-old Medicare rules originally meant to deter fraud and abuse, but now seen as a roadblock to coordinating better care for patients. The rules under revision were intended to counter self-dealing, as well as financial kickbacks among service providers such as hospitals, clinics and doctors. (AP Photo/Alex Brandon, File)