Earlier in July, the Centers for Medicare & Medicaid Services (CMS) announced plans to reimburse physicians for consultations regarding end-of-life planning. CMS’s new proposal compensates physicians who provide end-of-life counseling and educate Medicare beneficiaries about living wills and other end-of-life options. Points of discussion during these counseling sessions include clarifying patient values, setting goals for future care, distinguishing comfort and prolonging life, choosing a health care agent, and determining the individual’s preference on certain intervention, i.e., CPR, hospitalization, transfusion, etc. Counseling can educate patients on a range of options from minimal medical interventions to all life-sustaining treatment. Patients can choose whether or not to schedule end-of-life counseling to consider their quality of life, costs and burden of treatment, and concerns about death itself. CMS’s plan was released in the Medicare Physician Fee Schedule for Calendar Year 2016. The 815-page proposal updated other payment policies and rates as well as service quality provisions that will take effect on or after January 1, 2016. Comments regarding the proposed fee schedule will be accepted until September 8, 2015. The final rule will be issued by November 1, 2015.
End-of-life planning allows patients to express their wishes about end-of-life options in the event that they become unable to speak for themselves. While end-of-life counseling sessions have been highly controversial and misunderstood, end-of-life planning is advantageous and beneficial to the patient and his or her family, not disparaging. End-of-life planning allows an individual to make more informed decisions concerning his or her health care.
Advance directives are legal documents that allow individuals to state their wishes regarding medical treatment in advance of an illness or accident resulting in incapacity. A Declaration to Physicians (Living Will) is a document in which an individual can specify wishes regarding specific medical care (e.g. life-support, feeding tubes). This document does not allow an individual to appoint a health care agent. A Power of Attorney of Health Care is a broader document in which an individual can appoint a family member or friend as a health care agent to make health care decisions in the event of incapacity. In Wisconsin, if an individual does not have a Declaration to Physicians or a Power of Attorney of Health Care, and that individual does not have the capacity to make his or her own health care decisions, a guardianship hearing will be required.
LCOJ has several attorneys specializing in estate planning and health care law. Our attorneys can also assist with advance directive forms. If you have questions about CMS’s new proposal or end-of-life planning, or if you need assistance with advance directive forms, please contact our Health Care Team or our Estate Planning Team.