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Providers say end-of-life pay rule is an inch—they want a yard

Posted on 09/22/2015

Modern Healthcare — Providers have flooded the CMS with praise for its plan to pay physicians for end-of-life conversations and planning. But many say the proposal should go further.

The proposed policy was outlined amid a variety of policy changes in draft 2016 amendments to the Medicare physician fee schedule. Comments on the payment rule were due this week, and the agency received more than 2,000 of them.

The rule’s call for two new billing codes for advance care-planning drew significant attention because providers have long sought specific reimbursement for the conversations and because of the political controversy the matter has stoked in the past. Preliminary attempts among policymakers and lawmakers to address the matter in the Affordable Care Act became mired in the allegation by Sarah Palin and other conservatives that the law would establish “death panels” to restrict care.

The new codes would be used to pay for the time a provider spends discussing patient choices for advance directives and helping them complete forms. One code would cover the first 30 minutes and the other would cover any additional 30-minute blocks that are needed.

The activation of the code “does not mean that Medicare has made a national coverage determination regarding the service,” the agency said in the rule. “Contractors remain responsible for local coverage decisions in the absence of a national Medicare policy.”

And that is part of the problem, say some providers who are already spending plenty of staff time to have these conversations anyway.

Read the full article from Modern Healthcare here.