Obama Administration Backs Down On End-Of-Life Planning In Medicare
After the inevitable hyperbolic reaction to last weeks report that new Medicare regulations would include provisions to fund end-of-life counseling, the Obama Administration has apparently decided to back down yet again:
WASHINGTON — The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.
The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.
Many doctors and providers of hospice care had praised the regulation, which listed “advance care planning” as one of the services that could be offered in the “annual wellness visit” for Medicare beneficiaries.
While administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor. The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House.
Although the health care bill signed into law in March did not mention end-of-life planning, the topic was included in a huge Medicare regulation setting payment rates for thousands of physician services. The final regulation was published in the Federal Register in late November. The proposed rule, published for public comment in July, did not include advance care planning.
An administration official, authorized by the White House to explain the mix-up, said Tuesday, “We realize that this should have been included in the proposed rule, so more people could have commented on it specifically.”
“We will amend the regulation to take out voluntary advance care planning,” the official said. “This should not affect beneficiaries’ ability to have these voluntary conversations with their doctors.”
The November regulation was issued by Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services and a longtime advocate for better end-of-life care. White House officials who work on health care apparently did not focus on the part of the rule that dealt with advance care planning.
Quite honestly, I can’t help but think that this is largely related to the Administration’s fear of being caught up in another ridiculous “death panel” argument with the right. It’s unfortunate, though, because, whatever the reason, there’s really no reason why these types of conservations between doctors, patients, and families should not be encouraged to take place before they become a necessity.