Medicare May Cover End-of-Life 'Death Panel' Talks

Monday, 01 Sep 2014 10:56 AM

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Five years after the political firestorm over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year, The New York Times reports.

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Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations. People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between.

Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.
 
But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Assocation. One of the AMA’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.
 
The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts AMA  recommendations. And the political environment is less toxic than it was when the “death panels” label was coined; although there are still opponents, there are more proponents, including Republican politicians.
 
If Medicare adopts the change, its decision will also set the standard for private insurers, encouraging many more doctors to engage in these conversations.

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“We think it’s really important to incentivize this kind of care,” said Dr. Barbara Levy, chairwoman of the AMA committee that submits reimbursement recommendations to Medicare. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”
 

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