“A bill to amend title XVIII of the Social Security Act to waive cost-sharing for advance care planning services, and for other purposes.”
No CRS summary available for this bill.
This section establishes Medicare Part B coverage for advance care planning services (i.e., discussions by eligible practitioners—physicians, physician assistants, nurse practitioners, clinical nurse specialists, qualified clinical social workers, or others determined by the Secretary—of an individual's health care preferences, future decisions, and advance directives), as follows: (1) directs payment under the physician fee schedule for such services furnished on or after the date of enactment, limited to one applicable provider per period, non-duplicative of other Part B payments, and without requiring an annual wellness visit or initial preventive physical examination; (2) eliminates beneficiary coinsurance and Part B deductible for such services furnished on or after January 1, 2027 (currently, Part B pays 80% of reasonable charges after the deductible, with beneficiaries paying 20% coinsurance); (3) waives Medicare telehealth geographic restrictions for such services furnished on or after the date of enactment; and (4) updates definitions in the initial preventive physical examination and annual wellness visit provisions to reference the new definition.
This section directs the Secretary of Health and Human Services to conduct outreach, including a new comprehensive one-time education initiative, to Medicare-participating physicians and non-physician practitioners regarding Medicare payment for advance care planning services (i.e., discussions of health care preferences; HCPCS codes 99497 and 99498 or successors) as a covered benefit, including beneficiary eligibility requirements. Not later than one year after completing the outreach, the Secretary must submit a report to the Senate Committee on Finance and the House Committees on Ways and Means and Energy and Commerce describing the outreach methods used.
This section directs the Medicare Payment Advisory Commission (MedPAC) to conduct a study on advance care planning services under Medicare (title XVIII of the Social Security Act), including (1) providers trained or eligible to furnish such services to beneficiaries, visit length and frequency, and related barriers; (2) use of advance care planning Current Procedural Terminology (CPT) codes for billing, circumstances for using other codes, and barriers to CPT code usage; and (3) other appropriate items. MedPAC must submit a report with findings and recommendations for legislation and administrative action to the Senate Committee on Finance and the House Committees on Ways and Means and Energy and Commerce by June 30, 2027.