November 1, 2015

The official end of the "death panel" kerfuffle

On Friday, October 30, 2015, the Centers for Medicare & Medicaid Services (the branch of the Department of Health and Human Services that oversees Medicare and Medicaid) issued final rules about paying physicians to talk to patients about their advance care plan for end of life.
And about time, too.
For what I hope will be one of the last times, I will mention that this was a provision in the Affordable Care Act that was removed before passage, due to the perceived implication that it would result in "death panels," meaning that doctors would take the opportunity to steer patients toward refusing life prolonging measures. That is known as "default option" advance care planning. And, although there is quite a bit of that around, it is found in state statutes and state-recommended advance directive forms and not so much in physician/patient conversations about end-of-life care.  I digress.
The new rule, which will go into effect on January 1, 2016, will finally allow doctors to be paid to have a conversation with a patient about end-of-life planning other than at the "Welcome to Medicare!" visit or after a terminal diagnosis.
Because, let's face it, if advance care planning doesn't happen until a health care crisis occurs, it's not really "advance" care planning, is it?
Much more on this later, as I absorb the verbiage of the new rule and finish working on my latest project, which is the creation of a Universal Health Care Advance Directive form. It will not only be applicable in most of the United States but will also act as a guide for one of these long overdue physician-patient advance care planning conversations.