Forum of State Associations Letter Expresses Support for Advance Care Planning Services
Conveys Support for CMS Proposal to Activate Advance Care Planning Codes in CY2016
August 18, 2015 08:50 AM
The Forum of State Associations (Forum) is an affiliated organization of the National Association for Home Care & Hospice (NAHC). It is comprised of state home health, home care, and hospice associations from across the nation. A total of 41 member associations of the Forum sent a letter dated Tuesday, August 11, to the Centers for Medicare & Medicaid Services (CMS) that conveyed support for CMS’ plans to activate the Advance Care Planning codes in calendar year (CY) 2016 as indicated in the proposed physician payment rule. In July 2015, CMS released proposed changes to the Medicare physician fee schedule for CY2016, including payment to physicians for advance care planning sessions (see previous NAHC Report article here). NAHC had previously joined with other organizations in urging CMS to include coverage of such planning in the 2016 physician payment rule. In July, following CMS’ announcement of the proposed rule, NAHC President Val J. Halamandaris called the inclusion of advance care planning services, “a vital step toward improving quality of care and ensuring patient involvement and self-determination in the health care decision-making process.”
The Forum letter—addressed to CMS Acting Administrator Andy Slavitt—applauded CMS’ proposed action and leadership in the effort to include advance care planning services as part of the Medicare benefit. “The Forum is appreciative of the opportunity to express support for [CMS’] proposal to classify CPT codes 99497 and 99498 as “active” codes and to permit separate payment for them under the Medicare physician fee schedule,” the Forum stated in the letter.
The Forum explained the importance of expanding opportunities for home care and hospice patients to discuss their health care conditions, treatment options, and personal preferences. “In the fields of home care and hospice, the vast majority of patients served by our member agencies are senior citizens and persons with disabilities, many of whom have multiple chronic health conditions or are approaching the end of life. Based on the collective experience of home care and hospice professionals, there is significant need to expand existing opportunities for individuals to discuss their health care conditions, the range of treatment options, and their care goals to ensure that as the need for care arises it will be provided according to the individual’s personal preferences,” the Forum stated. “We believe that these opportunities should be available (at the beneficiary’s discretion) in conjunction with the annual wellness visit, as well as on an ongoing basis, as care preferences may change over time and with changing health status. Finally, to ensure that sufficient time and attention will be given to these important discussions, we support separate payment based on the time spent in provision of these advance care planning services.”
The full letter from the Forum is available here.
In related news, two members of the U.S. House of Representatives—Earl Blumenauer (D-OR) and Phil Roe, MD (R-TN)—also recently sent a letter to CMS expressing support for the inclusion of advance care planning services in the proposed rule. “Conversations about care at the end of life are critical to establishing and documenting patient values, goals, and preferences,” the lawmakers said in their letter. “We strongly support Medicare reimbursement for advance care planning services and urge CMS to make separate payment available for these services in CY 2016, as included in the recent proposed physician fee schedule.” The full letter from the Representatives is available here.