FILE - In this 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)