S. 2865: Improving Access to Advance Care Planning Act

The Improving Access to Advance Care Planning Act aims to enhance access to advance care planning services through Medicare. Here’s a breakdown of the key components of the bill:

Definition of Advance Care Planning Services

The bill defines advance care planning services as discussions provided by qualified practitioners regarding:

• The individual's health care preferences.
• Future health care decisions that may need to be made.
• Preparation of advance directives or standard forms for health care preferences.

Eligible practitioners include physicians, physician assistants, nurse practitioners, clinical nurse specialists, and clinical social workers who meet specified certification or experience requirements. Other practitioners may also be considered eligible as determined by the Secretary of Health and Human Services.

Encouragement of Advance Care Planning

The bill introduces financial incentives to promote advance care planning services:

• Medicare will make payments for these services starting from the date the law goes into effect.
• Payments will be made for only one provider per individual within a specified period.
• There will be no duplication of payments and no requirement for prior wellness visits to receive these services.

Cost-sharing Waivers

The legislation proposes to eliminate cost-sharing responsibilities for advance care planning services under Medicare, effective from January 1, 2027. This means beneficiaries will not have to pay deductibles or copayments for these services.

Telehealth Improvements

To improve access, the bill allows advance care planning services to be provided via telehealth, removing geographic limitations for these types of services starting from the effective date of the legislation.

Outreach Initiatives

The Secretary of Health and Human Services is tasked with conducting outreach to educate healthcare providers about the coverage and payment for advance care planning services under Medicare. This includes:

• A comprehensive education initiative to inform providers about new covered benefits.
• A report on the effectiveness of this outreach must be submitted within one year.

Study and Reporting Requirements

The bill mandates that the Medicare Payment Advisory Commission conduct a study examining:

• The provision of advance care planning services to Medicare beneficiaries.
• The use of CPT codes for billing these services.
• Barriers faced by providers and beneficiaries in accessing these services.

A report detailing the findings and recommendations from this study is required to be submitted by June 30, 2027.

Summary of Changes

This legislation seeks to reinforce the value of advance care planning by:

• Defining advance care planning services and ensuring coverage under Medicare.
• Waiving out-of-pocket expenses for such services.
• Promoting telehealth access to these consultations.
• Implementing educational outreach for healthcare providers.
• Conducting studies on the effectiveness and barriers of these services.

Relevant Companies

• None found