Medicare to pay doctors to provide end of life care

The new rule did not ignite the fierce fight that a similar measure did during the health law debate. Medicare officials also turned down requests from hospitals to change their plans for a controversial rule to determine which patients are considered out-patient status, and the Wall Street Journal examines how the federal government is curbing the auditors who check those hospital decisions.

Dr. Patrick Conway, the chief medical officer at the federal Centers for Medicare and Medicaid Services, said Friday that the final rule was similar to the proposal earlier this year.

“We received overwhelmingly positive comments about the importance of these conversations between physicians and patients,” Dr. Conway said.

Under the final rule, 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.

Under the rule, officials said, Medicare would pay $86 for the first 30 minutes of “advance care planning” in a doctor’s office and $80 for the service in a hospital. In both settings, they said, Medicare will pay up to $75 for 30 additional minutes of consultation. These standard amounts can be adjusted for differences in costs in different parts of the country.

The rule, proposed last summer and finalized Friday as part of broader doctor-payment regulations, takes effect Jan. 1. The counseling is entirely voluntary, and could take place during seniors' annual wellness visit or during regular office visits.  There are approximately 55 million Medicare beneficiaries in the United States.

The Kaiser Family Foundation provides a set of FAQs related to the new rule.