Medicare coverage of advance care planning services

(a) Advance care planning services defined Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection: (nnn) Advance care planning services (1) In general The term advance care planning services means services provided by an eligible practitioner (as defined in paragraph (2)) to an individual, a family member of such individual, a caregiver of such individual, or such individual’s representative, to discuss— (A) the health care preferences of such individual; (B) future health care decisions that may need to be made by, or on behalf of, such individual; and (C) advance directives or other standard forms, which may be completed by, or on behalf of, such individual. (2) Eligible practitioner For purposes of paragraph (1), the term eligible practitioner means— (A) a physician (as defined in subsection (r)); (B) a physician assistant (as defined in subsection (aa)(5)); (C) a nurse practitioner (as defined in subsection (aa)(5)); (D) a clinical nurse specialist (as defined in subsection (aa)(5)); (E) a clinical social worker (as defined in subsection (hh)(1)) who possesses— (i) a relevant care planning certification; or (ii) experience providing care planning conversations or similar services, as defined by the Secretary; or (F) any other practitioner determined appropriate by the Secretary.. (b) Encouraging advance care planning (1) Payment Section 1848(b) of the Social Security Act (42 U.S.C. 1395w–4(b)) is amended by adding at the end the following new paragraph: (13) Encouraging advance care planning services (A) In general In order to encourage advance care planning services, the Secretary shall, subject to subparagraph (B), make payments (as the Secretary determines to be appropriate) under this section for advance care planning services (as defined in section 1861(nnn)) furnished on or after the date of enactment of this paragraph. (B) Policies related to payment In carrying out this paragraph, with respect to advance care planning services, the Secretary— (i) shall make payment to only 1 applicable provider for such services furnished to an individual during a period; (ii) shall not make a payment under subparagraph (A) if such payment would be duplicative of a payment that is otherwise made under this title for such services; and (iii) shall not require that an annual wellness visit (as defined in section 1861(hhh)) or an initial preventive physical examination (as defined in section 1861(ww)) be furnished as a condition of payment for such services.. (2) Removing cost-sharing responsibilities for advance care planning services under part B of the Medicare program Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended— (A) in subsection (a)(1)— (i) in subparagraph (GG), by striking and at the end; and (ii) in subparagraph (HH), by striking the semicolon at the end and inserting the following:, and (II) with respect to advance care planning services (as described in section 1848(b)(13)) furnished on or after January 1, 2027, the amount paid shall be an amount equal to 100 percent of the lesser of the actual charge for such services or the amount determined under such section; and (B) in subsection (b), in the first sentence— (i) by striking, and (13) and inserting (13); and (ii) by striking section 1861(n). and inserting the following: section 1861(n), and (14) such deductible shall not apply with respect to advance care planning services (as described in section 1848(b)(13)) furnished on or after January 1, 2027. (c) Improvements To advance care planning through telehealth Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended— (1) in paragraph (4)(C)— (A) in clause (i), in the matter preceding subclause (I), by striking and (7) and inserting (7), and (10); and (B) in clause (ii)(X), by inserting or paragraph (10) before the period at the end; and (2) by adding at the end the following new paragraph: (10) Treatment of advance care planning services The geographic requirements described in paragraph (4)(C)(i) shall not apply with respect to telehealth services furnished on or after the date of enactment of this paragraph for purposes of furnishing advance care planning services (as defined in section 1861(nnn)).. (d) Aligning definitions Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended— (1) in subsection (ww)— (A) in paragraph (1), by striking end-of-life planning (as defined in paragraph (3)) and inserting advance care planning (as defined in subsection (nnn)); and (B) by striking paragraph (3); and (2) in subsection (hhh)(2)— (A) by redesignating subparagraph (I) as subparagraph (J); (B) by redesignating subparagraph (I) as subparagraph (J); and (C) by inserting after subparagraph (H) the following new subparagraph: (I) Advance care planning services (as defined in subsection (nnn))..