Medicare finalized end-of-life counseling rules

Medicare will Reimburse for End-Of-Life Counselling
Medicare will Reimburse for End-Of-Life Counselling

Medicare doctors will, for the first time, be reimbursed by the federal government for counseling sessions with patients wishing to discuss their end-of-life options, under final rules released by the Center for Medicare and Medicaid Services on October 30.

“As a physician and a son, I personally know how important these discussions are for patients and families,” Dr. Patrick Conway, Medicare’s chief medical officer, told the Associated Press. “We believe patients and families deserve the opportunity to discuss these issues with their physician and care team.”

The changes, proposed in July, are part of the CMS’ annual payment rules for Medicare providers. Although there is a general consensus in favor of reimbursing providers for such services, some disability rights advocates sought to delay the proposal, on the basis that the CMS should first develop new advance planning documents, countering the perceived message in many existing materials that people are “better off dead than disabled.”

“It is difficult to know how to undo the crushing, life ending damage already done and to prevent the proposed payment regulations from magnifying the negative impact of the horrendously anti-disability materials that already exist,” Not Dead Yet wrote in public comments submitted September 8 to the CMS . “But that should be a task that we can all agree on: the discrimination incorporated in existing materials must be eliminated and new materials must be developed, disseminated and promoted.”

The CMS’ new payment plans include one payment rate for an initial 30-minute counseling session, and a separate rate for additional 30-minute sessions. The CMS, after much discussion, declined to impose a limit on the number of available sessions.

The Affordable Care Act originally included a provision for funding end-of-life counseling. The CMS also proposed similar rules in 2010, but both plans were scrapped in the face of political pressure from critics, who accused the Obama Administration of creating “death panels.”

A CMS fact sheet on the Medicare payment rules for 2016 can be read here.