Rep. Earl Blumenauer (D-Oregon) recently introduced legislation to provide reimbursement to doctors for voluntary, personal consultations with their Medicare and Medicaid patients around advance care planning. Mr. Blumenauer has proposed the Personalize Your Care Act of 2011, explaining that “voluntary benefits for advance care planning are the best way to ensure that our healthcare system respects the individual wishes of patients.”
The measure, H.R. 1589, would reimburse doctors for such voluntary conversations with patients every 5 years, or more frequently based on changes in health status or care setting.
The timing of this legislation is no accident. Introduced on April 15, it was intended as a show of support for National Healthcare Decisions Day, which is now held each April 16. As I’ve written here previously, the goal of this national initiative is to raise awareness about and encourage people to express their health care wishes through conversations and in written advance directives.
Rep. Blumenauer’s bill is similar to legislative language that he included in the health care reform bill passed by the House in 2009, but which was not included in the final version of the bill passed by Congress. That language became the basis for the charge of federal “death panels” by some opponents of the reform bill in 2009. In H.R. 1589, Rep. Blumenauer appears to be stressing the optional nature of this proposed benefit, using the word “voluntary” in the title of his press release.
This time, the measure appears to apply only to patients covered under Medicare and Medicaid. Under the health reform bill, the provision would have covered all persons who would enroll in health insurance plans operating through the newly-created health insurance exchanges.
The legislation, according to Rep. Blumenauer, also “provides grants to states to create Physician Orders for Life Sustaining Treatment (POLST) programs, allows portability of advance directives across states, and requires standards to include completed advance care planning documents within a patient’s electronic health record.”
Thus far, the bill has gotten very little press. It has been referred to the House Committees on Energy and Commerce and Ways and Means. If you would like to be apprised of future developments, please let me know.
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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