AMA proposes Medicare pay for end-of-life counseling

The American Medical Association has proposed a new Medicare billing code for physicians who provide counseling for patients who want to write end-of-life directives, the New York Times reports. CMS will rule on the new billing code, which was attacked as setting up “death panels” when first proposed five years ago, later this fall.

A number of private insurance companies, who cover about a quarter of the nation's 50 million elderly beneficiaries through Medicare Advantage plans, already provide coverage of end-of-life medical planning.

“We think it's really important to incentivize this kind of care,” Dr. Barbara Levy, chairwoman of the AMA committee that recommends reimbursement codes, told the Times. “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.”

Earlier this year, Sens. Tom Coburn (R-Okla.) and Chris Coons (D-Del.) proposed legislation that would encourage advance directives. Rather than pay doctors, they would have Medicare pay $75 directly to any senior who writes an advance directive and makes it available to their caregivers.

The proposed law—“definitely designed to avoid pushback,” an aide to Dr. Coburn told Modern Healthcare last May—would turn the advisory role over to organizations that exist in 43 states to promote creation of physician orders for life-sustaining treatment (POLST).

The POLST national clearinghouse has sample forms and a staff for helping local groups promote creation of end-of-life directives.