,,ii #aahth ,,congress #b;d ,session ,s4 #c ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #bj 7legislative day1 ,december #af71 #bjbd,mr4 ,warner 7for himself1 ,ms4 ,collins1 ,ms4 ,baldwin1 and ,ms4 ,klobuchar7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to waive cost-sharing for advance care planning services1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,improving ,access to ,advance ,care ,planning ,act4 #b4 ,medicare coverage of advance care planning services 7a7 ,advance care planning services defined ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended by adding at the end the following new subsection3 7nnn7 ,advance care planning services 7#a7 ,in general ,the term advance care planning services means a visit between an eligible practitioner 7as defined in paragraph 7#b77 enrolled under section #ahff7;j7 and an individual1 a family member of such individual1 or a surrogate designated by such individual1 to discuss-- 7,a7 the health care preferences of such individual2 7,b7 future health care decisions that may need to be made by1 or on behalf of1 such individual2 and 7,c7 advance directives or other standard forms1 which may be completed by1 or on behalf of1 such individual4 7#b7 ,eligible practitioner ,for purposes of paragraph 7#a71 the term eligible practitioner means-- 7,a7 a physician 7as defined in subsection 7r772 7,b7 a physician assistant 7as defined in subsection 7aa77#e772 7,c7 a nurse practitioner 7as defined in subsection 7aa77#e772 7,d7 a clinical nurse specialist 7as defined in subsection 7aa77#e772 or 7,e7 a clinical social worker 7as defined in subsection 7hh77#a77 who possesses-- 7i7 a relevant care planning certification2 or 7ii7 experience providing care planning conversations or similar services1 as defined by the ,secretary4 4 7b7 ,no application of coinsurance or deductible under part ,b 7#a7 ,amount ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7,a7 in subparagraph 7,,gg71 by striking and at the end2 and 7,b7 in subparagraph 7,,hh71 by striking the semicolon at the end and inserting the following3 and 7,,ii7 with respect to advance care planning services 7as defined in section #ahfa7nnn77 furnished on or after ,january #a1 #bjbf1 the amounts paid shall be #ajj percent of the lesser of the actual charge for the services or the amount determined under the fee schedule established under section #ahdh7;b74 7#b7 ,waiver of application of deductible ,the first sentence of section #ahcc7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7b77 is amended-- 7,a7 by striking 1 and 7#ac7 and inserting 7#ac72 and 7,b7 by striking section #ahfa7n74 and inserting the following3 section #ahfa7n71 and 7#ad7 such deductible shall not apply with respect to advance care planning services 7as defined in section #ahfa7nnn77 furnished on or after ,january #a1 #bjbf4 7c7 ,effective date ,the amendments made by this section shall apply to items and services furnished on or after ,january #a1 #bjbf4 #c4 ,,hhs provider outreach 7a7 ,outreach ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall conduct outreach to physicians and appropriate non-physician practitioners participating under the ,medicare program under title ,,xviii of the ,social ,security ,act with respect to ,medicare payment for advance care planning counseling services furnished to individuals to discuss their health care preferences1 identified by ,healthcare ,common ,procedure ,coding ,system 7,,hcpcs7 codes #iidig and #iidih 7or any successor to such codes74 ,such outreach shall include a new1 comprehensive1 one-time education initiative to inform such physicians and practitioners of the addition of such services as a covered benefit under the ,medicare program1 including the requirements for eligibility for such services4 7b7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall submit to the ,committee on ,ways and ,means and the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,finance of the ,senate a report on the outreach conducted under subsection 7a74 ,such report shall include a description of the methods used for such outreach4 #d4 ,med,p,a,c report on the furnishing of advance care planning services and the use of advance care planning codes under the ,medicare program 7a7 ,study ,the ,medicare ,payment ,advisory ,commission 7in this section referred to as the ,commission7 shall conduct a study on advance care planning under the ,medicare program under title ,,xviii of the ,social ,security ,act4 ,such study shall include an analysis of-- 7#a7 the furnishing of advance care planning services to ,medicare beneficiaries1 including-- 7,a7 which providers are trained to provide such services2 7,b7 which providers are eligible to provide such services under the ,medicare program2 7,c7 the length and frequency of the visits for furnishing such services2 and 7,d7 any barriers related to providers furnishing1 or beneficiaries being furnished1 such services2 7#b7 the use of advance care planning ,current ,procedural ,terminology 7,,cpt7 codes to bill for the furnishing of advance care planning services to ,medicare beneficiaries1 including-- 7,a7 circumstances under which codes other than advance care planning ,,cpt codes are used to bill for such services under the ,medicare program and why providers do not use advance care planning ,,cpt codes2 and 7,b7 any barriers to providers using advance care planning ,,cpt codes to bill for such services under the ,medicare program2 and 7#c7 such other items determined appropriate by the ,commission4 7b7 ,report 7#a7 ,in general ,not later than ,june #cj1 #bjbf1 the ,commission shall submit to the ,committee on ,ways and ,means and the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,finance of the ,senate a report on the study conducted under subsection 7a71 together with recommendations for such legislation and administrative action as the ,commission determines appropriate4