I am truly sorry for such a long post today. But I feel
it is important. There are some of you out there who
has gotten the scare tactic email... either says Obama
trying to kill Granny, or look at page 425, Obama
killing off the elderly. So here you are, page 425 for
you to read for yourself.... and tell me where it says it
is going to kill anyone. Then go the bottom and see
what it means in common language. If the governement
one gets to be too much for you.. scroll down to the
lower part and I will tell you what it means.
Page 425
1 ‘‘(FF) advance care planning consultation (as
2 defined in subsection (hhh)(1));’’; and
3 (B) by adding at the end the following new
4 subsection:
5 ‘‘Advance Care Planning Consultation
6 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
7 term ‘advance care planning consultation’ means a con
8 sultation between the individual and a practitioner de
9 scribed in paragraph (2) regarding advance care planning,
10 if, subject to paragraph (3), the individual involved has
11 not had such a consultation within the last 5 years. Such
12 consultation shall include the following:
13 ‘‘(A) An explanation by the practitioner of ad
14 vance care planning, including key questions and
15 considerations, important steps, and suggested peo
16 ple to talk to.
17 ‘‘(B) An explanation by the practitioner of ad
18 vance directives, including living wills and durable
19 powers of attorney, and their uses.
20 ‘‘(C) An explanation by the practitioner of the
21 role and responsibilities of a health care proxy.
22 ‘‘(D) The provision by the practitioner of a list
23 of national and State-specific resources to assist con
24 sumers and their families with advance care plan
25 ning, including the national toll-free hotline, the ad-
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1 vance care planning clearinghouses, and State legal
2 service organizations (including those funded
3 through the Older Americans Act of 1965).
4 ‘‘(E) An explanation by the practitioner of the
5 continuum of end-of-life services and supports avail
6 able, including palliative care and hospice, and bene
7 fits for such services and supports that are available
8 under this title.
9 ‘‘(F)(i) Subject to clause (ii), an explanation of
10 orders regarding life sustaining treatment or similar
11 orders, which shall include—
12 ‘‘(I) the reasons why the development of
13 such an order is beneficial to the individual and
14 the individual’s family and the reasons why
15 such an order should be updated periodically as
16 the health of the individual changes;
17 ‘‘(II) the information needed for an indi
18 vidual or legal surrogate to make informed deci
19 sions regarding the completion of such an
20 order; and
21 ‘‘(III) the identification of resources that
22 an individual may use to determine the require
23 ments of the State in which such individual re
24 sides so that the treatment wishes of that indi
25 vidual will be carried out if the individual is un-
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427
1 able to communicate those wishes, including re
2 quirements regarding the designation of a sur
3 rogate decisionmaker (also known as a health
4 care proxy).
5 ‘‘(ii) The Secretary shall limit the requirement
6 for explanations under clause (i) to consultations
7 furnished in a State—
8 ‘‘(I) in which all legal barriers have been
9 addressed for enabling orders for life sustaining
10 treatment to constitute a set of medical orders
11 respected across all care settings; and
12 ‘‘(II) that has in effect a program for or
13 ders for life sustaining treatment described in
14 clause (iii).
15 ‘‘(iii) A program for orders for life sustaining
16 treatment for a States described in this clause is a
17 program that—
18 ‘‘(I) ensures such orders are standardized
19 and uniquely identifiable throughout the State;
20 ‘‘(II) distributes or makes accessible such
21 orders to physicians and other health profes
22 sionals that (acting within the scope of the pro
23 fessional’s authority under State law) may sign
24 orders for life sustaining treatment;
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1 ‘‘(III) provides training for health care
2 professionals across the continuum of care
3 about the goals and use of orders for life sus
4 taining treatment; and
5 ‘‘(IV) is guided by a coalition of stake
6 holders includes representatives from emergency
7 medical services, emergency department physi
8 cians or nurses, state long-term care associa
9 tion, state medical association, state surveyors,
10 agency responsible for senior services, state de
11 partment of health, state hospital association,
12 home health association, state bar association,
13 and state hospice association.
14 ‘‘(2) A practitioner described in this paragraph is—
15 ‘‘(A) a physician (as defined in subsection
16 (r)(1)); and
17 ‘‘(B) a nurse practitioner or physician’s assist
18 ant who has the authority under State law to sign
19 orders for life sustaining treatments.
20 ‘‘(3)(A) An initial preventive physical examination
21 under subsection (WW), including any related discussion
22 during such examination, shall not be considered an ad
23 vance care planning consultation for purposes of applying
24 the 5-year limitation under paragraph (1).
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1 ‘‘(B) An advance care planning consultation with re
2 spect to an individual may be conducted more frequently
3 than provided under paragraph (1) if there is a significant
4 change in the health condition of the individual, including
5 diagnosis of a chronic, progressive, life-limiting disease, a
6 life-threatening or terminal diagnosis or life-threatening
7 injury, or upon admission to a skilled nursing facility, a
8 long-term care facility (as defined by the Secretary), or
9 a hospice program.
10 ‘‘(4) A consultation under this subsection may in
11 clude the formulation of an order regarding life sustaining
12 treatment or a similar order.
13 ‘‘(5)(A) For purposes of this section, the term ‘order
14 regarding life sustaining treatment’ means, with respect
15 to an individual, an actionable medical order relating to
16 the treatment of that individual that—
17 ‘‘(i) is signed and dated by a physician (as de
18 fined in subsection (r)(1)) or another health care
19 professional (as specified by the Secretary and who
20 is acting within the scope of the professional’s au
21 thority under State law in signing such an order, in
22 cluding a nurse practitioner or physician assistant)
23 and is in a form that permits it to stay with the in
24 dividual and be followed by health care professionals
25 and providers across the continuum of care;
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430
1 ‘‘(ii) effectively communicates the individual’s
2 preferences regarding life sustaining treatment, in
3cluding an indication of the treatment and care de
4 sired by the individual;
5 ‘‘(iii) is uniquely identifiable and standardized
6 within a given locality, region, or State (as identified
7 by the Secretary); and
8 ‘‘(iv) may incorporate any advance directive (as
9 defined in section 1866(f)(3)) if executed by the in10
dividual.
11 ‘‘(B) The level of treatment indicated under subpara
12 graph (A)(ii) may range from an indication for full treat
13 ment to an indication to limit some or all or specified
14 interventions. Such indicated levels of treatment may in
15 clude indications respecting, among other items—
16 ‘‘(i) the intensity of medical intervention if the
17 patient is pulse less, apneic, or has serious cardiac
18 or pulmonary problems;
19 ‘‘(ii) the individual’s desire regarding transfer
20 to a hospital or remaining at the current care set21
ting;
22 ‘‘(iii) the use of antibiotics; and
23 ‘‘(iv) the use of artificially administered nutri24
tion and hydration.’’.
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431
1 (2) PAYMENT.—Section 1848(j)(3) of such Act
2 (42 U.S.C. 1395w-4(j)(3)) is amended by inserting
3 ‘‘(2)(FF),’’ after ‘‘(2)(EE),’’.
4 (3) FREQUENCY LIMITATION.—Section 1862(a)
5 of such Act (42 U.S.C. 1395y(a)) is amended—
6 (A) in paragraph (1)—
7 (i) in subparagraph (N), by striking
8 ‘‘and’’ at the end;
9 (ii) in subparagraph (O) by striking
10 the semicolon at the end and inserting ‘‘,
11 and’’; and
12 (iii) by adding at the end the fol
13 lowing new subparagraph:
14 ‘‘(P) in the case of advance care planning
15 consultations (as defined in section
16 1861(hhh)(1)), which are performed more fre
17 quently than is covered under such section;’’;
18 and
19 (B) in paragraph (7), by striking ‘‘or (K)’’
20 and inserting ‘‘(K), or (P)’’.
21 (4) EFFECTIVE DATE.—The amendments made
22 by this subsection shall apply to consultations fur
23 nished on or after January 1, 2011.
24 (b) EXPANSION OF PHYSICIAN QUALITY REPORTING
25 INITIATIVE FOR END OF LIFE CARE.—
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1 (1) PHYSICIAN’S QUALITY REPORTING INITIA
2 TIVE.—Section 1848(k)(2) of the Social Security Act
3 (42 U.S.C. 1395w–4(k)(2)) is amended by adding at
4 the end the following new paragraphs:
5 ‘‘(3) PHYSICIAN’S QUALITY REPORTING INITIA
6 TIVE.—
7 ‘‘(A) IN GENERAL.—For purposes of re
8 porting data on quality measures for covered
9 professional services furnished during 2011 and
10 any subsequent year, to the extent that meas
11 ures are available, the Secretary shall include
12 quality measures on end of life care and
13 advanced care planning that have been adopted or
14 endorsed by a consensus-based organization, if
15 appropriate. Such measures shall measure both
16 the creation of and adherence to orders for life
17 sustaining treatment.
18 ‘‘(B) PROPOSED SET OF MEASURES.— The
19 Secretary shall publish in the Federal Register
20 proposed quality measures on end of life care
21 and advanced care planning that the Secretary
22 determines are described in subparagraph (A)
23 and would be appropriate for eligible professionals to use
to submit data to the Secretary.
25 The Secretary shall provide for a period of comment on such
set of measures before finalizing such proposed measures.’’.
This only means IF you want to talk to your doctor about advance care planning...Medicare will pay for one session with your Dr.
Every 5 years... Which by the way, you are charged for it right now....
anyone who has worked in the health voc. like myself.... would have telling
you to do this... I did it years ago.. about 10 years ago, I have a living will written... I sent a copy to my kids and said if you have any problems with this...let's talk about it now... not fighting with your siblings while I am half dead in a bed, that I don't want to be in anymore. None of them wrote back... some of them did mention to me on the phone they did not have a problem with this. My doctor has a copy of it...
So yes, YOU SHOULD BE TALKING ABOUT IT NOW.. I don't care if you are
only 31 years old... Look what happen to Terri S. in Florida...
heck the whole nation got in on that one... So..
those who are reading the scare emails about how they want to kill granny....
it is based on lies... and this is what it says...
NOT YOU HAVE TO.. but YOU CAN.. IF YOU CHOSE... to talk to your doc.
and Medicare will pay for it..if you are 65, otherwise it is
you paying for it. Or you can go to the local stationary/office
supply store and pay $6.50 like I did.. and fill in the blanks yourself.
I don't know about you..but I sure don't want the hospital getting rich
off of my body... by testing it for everything they can think of...
I want to control ..... I don't want to be laying in bed for 5 years
on a tube feeding, not knowing anyone.
So chose for yourself... put on your big boy/girl pants and
take care of business and stop listen to every yahoo
who tries to tell you about the boogie man coming.
