New Physician Payment Final Rule Includes Voluntary Advance Care Planning

The Centers for Medicare and Medicaid Services (CMS) pre-posted the 2000+ page physician payment final rule and comments on the Office of the Federal Register (OFR) website.  Formal publication in the Federal Register is projected to be November 29, 2010.  The final rule includes reimbursement requirements for the new annual wellness/preventive care exam under the Medicare changes that were included in the health care reform bill.  In response to comments urging CMS to require that physicians offer voluntary advance care planning as part of the annual exam. CMS agreed!

A legislative provision to offer voluntary advance care planning every five years was dropped from the health care reform bill because of hysteria over government encouraged euthanasia.  This approach to the annual wellness exam restores some sanity to the picture.  Advance care planning has already been a required part of the “Welcome to Medicare” since the Medicare Modernization Act of 2003, and since advance care planning requires an ongoing effort, it makes a lot of sense to revisit it at least annually.  This is a big step forward in normalizing advance care planning.

You can access the final rule and comments at: http://www.ofr.gov/OFRUpload/OFRData/2010-27969_PI.pdf
The relevant pages are pp. 766-768 for the commentary and pp. 1488-1494 for the annual exam requirements.