Brace Yourself for another Round of Death Panel Debate

Remember the notorious “death panel” debate of 2009?  Congress was considering a proposal to pay doctors for end-of-life counseling.  Former vice presidential candidate Sarah Palin led the attack on the proposal, claiming that “death panels” would decide who lived and who died.  Many conservatives jumped on the band wagon, and the proposal met with a death of its own.

CMS may have reignited the debate on July 8 with the release of an 815-page proposed rule for the 2016 Medicare physician fee schedule.  The rule includes two billing codes for “advance care planning.”  One would cover an initial 30-minute counseling session; another would cover an additional 30-minute conversation.  In each session the physician would explain treatment options and then document the patient’s decision.

The American Medical Association immediately praised the proposal and criticized past mischaracterization of end-of-life counseling by its opponents.  In contrast, last December a group called Alliance for Defending Freedom argued that some patients are erroneously diagnosed as being in a persistent vegetative state and then die because of advance directives to withdraw life support.

CMS invites comments on the advance-care-planning proposal and the rest of the proposed rule.  They’re due by September 8

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