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End-of-life planning would be covered under Medicare proposal

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(Bloomberg) — Medicare may begin paying doctors to discuss end-of-life care with U.S. patients, under rules proposed Wednesday by the Obama administration.

Doctors who see patients in Medicare, the insurance program for the elderly, would be reimbursed for having the complex and sensitive conversations needed to plan for the end of life. Talks may include outlining the sorts of medical treatments patients desire, or helping to fill out standard forms about how they should be cared for if they’re unable to make decisions for themselves.

The idea caused a political uproar during debate over President Barack Obama’s 2010 health-care overhaul. Opponents declared the conversations a step toward “death panels” that would have the government ration care for the elderly and infirm. The administration’s proposal says the discussions should occur in the context of medical treatment.

“Conversations among physicians, patients, and loved ones is the standard of care,” Wayne J. Riley, president of the American College of Physicians, which represents internists, said in an e-mail. He said the group is pleased that Medicare “has recognized what the medical community is doing to address the needs and requests made by patients and their loved ones.”

The college was among several medical groups pushing for Medicare to pay for the planning.


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