UPDATE: I just spoke with an Obama Administration official who said the new proposed rule would be published at 4:15pm today in the Federal Register. This will allow for comment. He also confirmed to me that the advance care planning provision remains in the initial Welcome to Medicare visit with a physician. That provision was included by via statute during the Bush Administration in 2008. In other words, all of the bluster from social conservatives is a bit late. The Administration official indicated that the rule had been removed in order to give the public opportunity to indicate their views on the issue. He noted the misrepresentation of the issue and the Administration did not want the political process to jeopardize the existing benefits.
Annual voluntary advance care planning, we hardly knew ya.
Last week, I defended a new Medicare regulation which would have added advance end-of-life care planning to the definition of what could take place during the new Annual Wellness Visits authorized by the Affordable Care Act (ACA), otherwise known as ObamaCare. Some conservatives demonized this rule as the return of “death panels” in an effort to frighten voters. I don’t know whether or not the public was frightened, but according to the New York Times, these false characterizations scared the administration so much that the rule is being deleted.
And this is sad because this is case where spin and misinformation won out over fact and good sense. The truth is the Medicare regulation did not create a new reimbursable benefit and did not bring back “death panels.” The regulation added one voluntary component to the annual wellness visit – a discussion of the patients’ wishes if they become unable to express themselves during illness or injury. Physicians were not going to be paid separately for this conversation; they will still do the annual wellness visit and focus on many other issues of prevention and health maintenance. And here is the kicker, physicians can still bring up advance care planning if they want to.
Social conservatives who ranted about government involvement in end-of-life decision either had not read the regulation or were intentionally misleading people.
But now the administration without attribution has shifted course and it is quite unclear why.
Since yesterday morning, I have been seeking answers from the HHS press office and will comment more as I get more information.
Here is an AP piece on the matter…