In a bipartisan show of support, the Improving Access to Advanced Care Planning Act bill was filed today by long-time patient rights champions Rep. Blumenauer (D-OR-3), as H.R8840 in the House, and Sen. Warner (D-VA), Sen. Collins (R-ME), Sen. Baldwin (D-WI), and Sen. Klobuchar (D-MN) have introduced S.4873 in the Senate.
This bill aims to 1. remove the copay (cost-sharing) for Advance Care Planning (ACP) for beneficiaries enrolled in Medicare Advance Care Planning (ACP) counseling in all situations; 2. include licensed clinical social workers in the definition of eligible practitioners who can bill for Medicare ACP counseling services; 3. educate providers about the ACP counseling codes and the value of the ACP Counseling; and 4. direct MEDPAC to do a study to evaluate ACP under the Medicare program.
Advance care planning (ACP) is a process that helps people plan for future medical decision-making and is the foundation of person-centered care, and yet faces many barriers to widespread use. Medicare billing codes for advance care planning were designed to reimburse certain clinicians for having these important conversations. However, as a Part B Medicare service, ACP carries a 20 percent patient cost-sharing (copay). The latest available data showed a total of $104.5 million paid by patients in ACP copays in 2017, not a small amount of money, and research shows providers avoid offering ACP to save their patients these charges. Further evidence shows that these copays disproportionately affect communities of color. Beyond the patient cost, the billing codes allow only physicians, nurse practitioners, and physician assistants to be reimbursed by Medicare for ACP. This contrasts with systems like the Veterans Administration (VA) where social workers handle these conversations. Therefore, patient cost sharing and the limit on how many clinicians can bill for these services combine to reduce access to this important process, especially among historically disadvantaged communities.
The Coalition to Transform Advanced Care (C-TAC) has spent the last two years working to remove ACP barriers. After many attempts, C-TAC was unable to have ACP designated as a preventive service by the US Preventive Service Task Force, which would have removed the copay as a preventive service, and The Centers for Medicare and Medicaid (CMS) confirmed they lacked statutory authority to make this change as well. The same is true for allowing social workers to bill for ACP, so C-TAC turned its efforts to Capitol Hill.
“Those of us working to improve care for those impacted by serious illness have known that high copays for ACP were a barrier to equitable, patient-centered care. Thanks to the tenacity of our C-TAC team and members of Congress passionate about our issue, we’ve been able to help remedy this technicality in the bill that would increase access to critical conversations between patients and their clinicians,” says Jon Broyles, CEO of C-TAC.
Susan Nelson, MD, C-TAC member and System Chair of Palliative Medicine and Supportive Care and Bioethics at Oschner Health stated, “removing the copayment for this important part of a patient’s treatment plan puts its status on par with cancer screenings and vaccinations!”
C-TAC thanks the members of Congress for continuing to be the voice and champion for patients and families. C-TAC also encourages the public to 1. write their members of Congress to ask for their support of the Improving Access to Advanced Care Planning Act; 2. share their stories on the importance of ACP on social media using the hashtag #ACPequity and @Mentioning their elected officials and; 3. Spread the word about this bill to others.
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Join C-TAC and our Legislative Champions for a Q&A – Thursday, September 29th at 2pm ET
ACP Bill | Policy Update and Q&A – The Coalition to Transform Advanced Care (thectac.org)
Event Schedule:
Bill Overview
Co-Sponsors / Staff will speak to the Bill and what it hopes to accomplish
C-TAC Policy / ACP Experts on how it relates to the Coalition strategic plan, and our goals with Health Equity
Q&A – Questions from Members / Press
Next steps in supporting the ACP Bill Efforts
For more information, please contact Luke Scuitto at LScuitto@thectac.org
ABOUT
The Coalition to Transform Advanced Care (C-TAC) is dedicated to improving the lives of underserved and under-resourced people impacted by serious illness. We work with regulators, legislators, advocates, and funders to craft policies that ensure more equitable, comprehensive, accessible care and support for patients, families and unpaid caregivers. Nonprofit and nonpartisan, we are recognized as an unbiased source of expertise on serious illness and a respected convener of more than 190 organizations that share our vision of a healthcare system that serves patient needs and honors their dignity. For more information on our work and members, please visit https://www.TheCTAC.org
INTERVIEWS
C-TAC can introduce the media to health plans, health systems, hospice providers, community-based organizations and patient advocates who can provide background and quotes. See our Media / Press Page here.
For media inquiries, please contact Jim McGuire at jmcguire@thectac.org or direct at (770) 842-6329.
