Just last month I wrote about how Medicare would begin reimbursing physicians to have voluntary discussions with patients about the patients’ health care wishes, as part of patients’ annual wellness visits with them. But just last week, the administration reversed itself. This provision has now been removed from new Medicare regs that went into effect January 1.
According to the Obama administration, the change is because of a procedural error. Specifically, it had not included the advance care planning provision in the proposed Medicare regulations, and explains that it feels it did not give interested parties sufficient opportunity to comment on it. (There were, however, comments submitted about its absence from the proposed regs).
The reversal is also thought by some to be part of a political calculus: that the administration did not want this issue to be a lightning rod as the House considers repealing the health reform law. As you may recall, the charge that the health reform law would create “death panels” was levied against a provision in the original House bill that is similar to the provision that was just removed from the new regulations.
Even with this reimbursement provision removed, doctors and their Medicare patients can still have voluntary discussions about advance care planning – including whom patients want as surrogate decision makers and how their patients think about the care and the qualities of life they want to have if they can’t voice their own opinions. It’s just that doctors can’t be reimbursed specifically for doing so with patients who want to have this important discussion.
If you’d like to be kept abreast of new developments on this topic, please let me know at firstname.lastname@example.org.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 175,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. Randi is an ongoing contributor to the Academy blog.
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