Medicare proposes end-of-life advance care planning coverage plan

July 10, 2015
by Thomas Dworetzky, Contributing Reporter
With death panel fears from six years ago now thoroughly debunked, CMS has released a way for Medicare to pay doctors for end-of-life counseling, according to numerous news reports.

The American Medical Association applauded the move. Stated its president-elect, Dr. Andrew W. Gurman, "the proposed Medicare payment rule affirms the need to support conversations between patients and physicians to establish and communicate the patient's wishes in responding to various medical situations."

Gurman added, according to the Washington Post and other news organizations, that this patient-centered policy will support a careful planning process, adding that "this issue has been mischaracterized in the past and it is time to facilitate patient choices about advance care planning decisions."

The AMA has been supportive of such advance care coverage in the past, as have numerous senior groups, including AARP.

"Today's proposal supports individuals and families who wish to have the opportunity to discuss advance care planning with their physician and care team, as part of coordinated, patient- and family-centered care," said Dr. Patrick Conway, CMS' principal deputy administrator, according to CNN Money.

Many still fear "death panels" according to public polling experts, despite evidence to the contrary. Rigorous research has shown that seriously ill patients derive significant benefits from advance care planning and having their end-of-life wishes known, documented and respected, Allan Coukell, senior director for health programs at the Pew Charitable Trusts, told the Washington Post.

The proposed policy will be given a period for public comment and is now slated to take effect next year. It has been based on various recommendations for billing codes developed by the AMA in 2015, according to Politico.

CMS stated in its recent fact sheet concerning this new reimbursement proposal that, "consistent with recommendations from the American Medical Association (AMA) and a wide array of stakeholders, CMS proposes to establish separate payment and a payment rate for two advance care planning services provided to Medicare beneficiaries by physicians and other practitioners.

The Medicare statute currently provides coverage for advance care planning under the "Welcome to Medicare" visit available to all Medicare beneficiaries, but they may not need these services when they first enroll. Establishing separate payment for advance care planning codes provides beneficiaries and practitioners greater opportunity and flexibility to utilize these planning sessions at the most appropriate time for patients and their families."

The "death panel" charge made by Sarah Palin and others, was dubbed "Lie of the Year" in 2009 by PolitiFact.