Death Panels are Finally Gone.

Death Panels are Finally Gone. The New York Times, Nov 2/2015

Following six years of intense legislation end of life planning and expenses applicable thereto will be authorized and paid for by Medicare. As one may recall the initial discussion regarding this care began in 2009 with the opposition labeling this service as the “death panels.” The final rule ended up almost exactly as the initial one proposed six years ago. In the final draft, overwhelming support for these services was the bi-partisan response.

The final rule said, “patients and families can have the discussions when and where they want; before patients become ill, after they receive a diagnosis of cancer or other serious illness, or while they are receiving hospice or palliative care.” Details about the patients’ right to discuss how (or if) they would want to be kept alive if they became unable to express these wishes. Under the most debate was the ideal that physicians should or should not advise regarding end of life planning. The result was that doctors can advise patients for end-of-life care, to include treatment or lack thereof at various stages.

A payment schedule was devised with reimbursements to physicians of about $80 for ½ hour of advice/consultation. January 2016 is the kick-off date for coverage as CMS has already created the appropriate billing codes for these services.

The key phrase of the legislation is that such planning is at the discretion of the beneficiary thus eliminating the fear of “pulling the plug on Grandma” or the 2009 phrase “death panel.”

Endorse by The American Hospital Association this rule provides a significant improvement in patient treatment preferences. In agreement by both sides of the aisle is that “Congress could do more by passing legislation to promote the education of doctors and patients, and to develop “quality measures” to ensure that end-of-life care is consistent with wishes of patients.”