Good news from the world of advance care planning legislation. On June 10, Senators Johnny Isakson (R-GA) and Mark Warner (D-VA) introduced the Care Planning Act of 2015.
The key provision of this bipartisan bill is a new Medicare benefit called “Planning Services.” This would provide the opportunity for your clients who have Medicare and also have an advanced or terminal illness to work with an interdisciplinary team of specialists to help them determine and articulate their health care wishes, coordinate all aspects of their care to meet those defined goals, and put those wishes into an advance directive. Medicare would then reimburse physicians for participating in this care coordination. The money is the part that has been missing.
Clearly, your clients already have the advance directive. But for those with complicated medical issues, having their care coordinated with their team of specialists, and ensuring that all their doctors are clear on their goals for living as well as for their health – this is probably not happening easily (or at all) for many, if not most.
Should the bill pass, your clients with health insurance through Medicare could elect to take advantage of this benefit. Otherwise, their care will continue to be as coordinated or uncoordinated as it is presently. As a quality control measure, the bill also calls for the Department of Health and Human Services to develop a system to test the effectiveness of Planning Services, and whether or not participating Medicare beneficiaries’ wishes are truly being met.
Several health care organizations were quick to make known their support of the bill. Both the Coalition to Transform Advanced Care (of which I am a member) and the American Academy of Family Physicians put out articles shortly after the bill’s introduction stating what a great achievement it will be to have such a law in place.
The idea of making advance care planning available through Medicare is not new, but the larger bipartisan support for the bill is. An earlier version of the bill was presented back in 2013. While the former only enjoyed the support of Senators Warner and Isakson, the current iteration is co-sponsored by 4 other senators – Tammy Baldwin (D-WI), Shelley Capito (R-WV), Susan Collins (R-ME) and Amy Klobuchar (D-MN) – 2 more Democrats and 2 more Republicans. As with Jeb Bush’s statements that I wrote about last month, this is a sign that discussing practical measures for advance care planning is becoming a more acceptable, mainstream idea, and that perhaps the clamor over “death panels” is on the wane.
Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), which ensures that the emergency information and healthcare directives of its 200,000+ enrollees are available 24/7/365 through the largest advance directives registry in the U.S., as well as access to an online safe for storage of digital assets and other vital documents. 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. A member of the Philadelphia Estate Planning Council, the International Society of Advance Care Planning and the Coalition to Transform Advanced Care, Randi is active in health education and public engagement related to advance care planning/advance directives. She serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative and as a board member of the Center for Advocacy for the Rights and Interests of the Elderly. Randi is an ongoing contributor to the Academy blog.
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