Crucial Decisions on End-of-Life Medical Care Could Be Made In Consultation with Doctors In Advance of Incapacitation
TRENTON – The crucial decisions about end-of-life medical care made in advance of incapacitating conditions would be supported by Medicaid, according to legislation sponsored by Senator Richard J. Codey and Senator Joseph F. Vitale. The bill, S-2435, requiring Medicaid reimbursement for advance care planning consultations with doctors or other caregivers, was voted out of the Senate Budget and Appropriations Committee today.
“As our population ages in New Jersey, there is a growing need for people to have those often-difficult conversations with their doctors or trusted health care providers about their wishes should they become unable to make their own future health care decisions. Those conversations should be supported by Medicaid and Medicare, and not be financially burdensome on the elderly or terminally ill,” said Senator Codey (D-Essex, Morris). “Such advance medical directives are the only way of ensuring that incapacitated patients are treated and cared for by their caregivers according to their own wishes.”
Advance care planning is the practice of preparing explicit written instructions for caregivers, family and friends on the type of care that should be provided or withheld, including palliative care, in case of incapacitation.
“This is about preserving a person’s dignity in the event that he or she is unable to make or communicate decisions about the delivery of his or her own care at a future date. It is about ensuring that everyone has a voice – their own voice – as they age and as they near the end of their life,” said Senator Vitale (D-Middlesex). “Such decisions about future medical care should be informed decisions, made with input from medical professionals, and it is important that they take place before a crisis happens.”
The American Medical Association recently recommended that Medicare provide reimbursement for the practice. The Medicare statute currently provides coverage for advance care planning under the “Welcome to Medicare” visit available to all Medicare beneficiaries, but they may not need these services when they first enroll. Starting in 2016, Medicare will begin covering advance care planning as a separate and billable service.
Two states, Colorado and Oregon, have already moved forward on similar legislation by approving Medicaid payments for the consultative care.
Once the government-sponsored programs adopt this change, it would set a standard for private insurers and encourage more doctors to engage in these conversations with their patients, Senator Codey pointed out.
“Coverage would result in raised awareness and increased use of this valuable service, and allow residents to make decisions with greater comfort on end-of-life care,” said Senator Codey.
The bill cleared the committee with a vote of 9-3. It now heads to the full Senate for consideration.