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Medicare Considers Paying Doctors for End-of-Life Counseling

Plan would take effect in January

Medicare has announced plans to reimburse doctors for conversations with patients about whether and how they would want to be kept alive if they became too sick to speak for themselves, according to an article in the New York Times.

The new plan is expected to be approved and to take effect in January 2016, although it will be open to public comment for 60 days.

Medicare’s plan comes as many patients, families, and health providers are pushing to give people greater say about how they die — whether that means trying every possible medical option to stay alive or discontinuing life support for those who do not want to be sustained by ventilators and feeding tubes.

Dr. Patrick Conway, the chief medical officer for the Centers for Medicare & Medicaid Services, said a final decision on the proposal would be made by November 1. The plan would allow qualified professionals, such as nurse practitioners and physician assistants, as well as doctors, to be reimbursed for face-to-face meetings with a patient and any relatives or caregivers that the patient wants to include. Conway said the proposal did not limit the number of conversations reimbursed.

The reimbursement rate paid under the proposal and other details will be determined after public comments are received, Conway said. People covered by Medicare account for about 80% of deaths each year.

Last September, a national nonpartisan panel of medical, legal, and religious leaders issued a report saying that the country’s system for dealing with end-of-life care was seriously flawed and should be overhauled. Among its recommendations was that insurers reimburse health providers for care-planning conversations.

Source: New York Times; July 8, 2015.

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