Administration renews call to reimburse doctors for end-of-life care planning

WASHINGTON – Six years after end-of-life planning nearly derailed development of the Affordable Care Act amid charges of “death panels,” the Obama administration has revived a proposal to reimburse physicians for talking with their Medicare patients about how patients want to be cared for as they near death.

The proposal, contained in a large set of Medicare regulations unveiled Wednesday, comes amid growing public discussion about the need for medical care that better reflects patients’ wishes as they get older.

Two months ago, former Florida Gov. Jeb Bush, one of the front-runners for the Republican presidential nomination in 2016, suggested that Medicare patients should sign so-called advance directives that spell out the care they want if they become incapacitated.

The American Medical Association has recommended the Medicare billing change.

The proposal from the Department of Health and Human Services would not require Medicare patients to sign any order or talk with their physicians about end-of-life care.

Rather, the proposed regulation would allow medical providers to bill Medicare for “advance-care planning” should a patient want that discussion.

Such a session could include “the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed) by the physician or other qualified health professional,” according to the proposed rule.

Medicare currently provides coverage to more than 50 million mostly older Americans and is projected to grow steadily as baby boomers retire.