,,ii  #aah? ,,congress  #b;d ,session   
,s4 #c  ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ 
,,/ates  ,decemb] #bj 7legislative day1 
,decemb] #af71 #bjbd,mr4 ,w>n] 7=       
himself1 ,ms4 ,coll9s1 ,ms4 ,baldw91 &  
,ms4 ,klobu*>7 introduc$ ! foll[+ bill2 
:i* 0 read twice & ref]r$ to !          
,committee on ,f9ance  ,a ,,bill  ,to   
am5d title ,,xviii ( ! ,social ,security
 ,act to waive co/-%>+ = advance c>e    
plann+ s]vices1 & = o!r purposes4  #a4  
,%ort title ,?is ,act may be cit$ z !   
,improv+ ,access to ,advance ,c>e       
,plann+ ,act4  #b4 ,m$ic>e cov]age (    
advance c>e plann+ s]vices  7a7 ,advance
 c>e plann+ s]vices def9$ ,section #ahfa
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7 is am5d$ by add+ at ! 
end ! foll[+ new subsection3  7nnn7     
,advance c>e plann+ s]vices  7#a7 ,9    
g5]al ,! t]m advance c>e plann+ s]vices 
means a visit betwe5 an eligible        
practition] 7z def9$ 9 p>agraph 7#b77   
enroll$ "u section #ahff7;j7 & an       
individual1 a family memb] ( su*        

individual1 or a surrogate designat$ by 
su* individual1 to discuss-- 7,a7 !     
heal? c>e pref]5ces ( su* individual2   
7,b7 future heal? c>e decisions t may   
ne$ to be made by1 or on behalf (1 su*  
individual2 &  7,c7 advance directives  
or o!r /&>d =ms1 :i* may be complet$ by1
 or on behalf (1 su* individual4  7#b7  
,eligible practition] ,= purposes (     
p>agraph 7#a71 ! t]m eligible           
practition] means-- 7,a7 a physician 7z 
def9$ 9 subsection 7r772  7,b7 a        
physician assi/ant 7z def9$ 9 subsection
 7aa77#e772  7,c7 a nurse practition] 7z
 def9$ 9 subsection 7aa77#e772  7,d7 a  
cl9ical nurse speciali/ 7z def9$ 9      
subsection 7aa77#e772 or  7,e7 a cl9ical
 social work] 7z def9$ 9 subsection     
7hh77#a77 :o possesses-- 7i7 a relevant 
c>e plann+ c]tification2 or  7ii7       
exp]i5ce provid+ c>e plann+ conv]sations
 or simil> s]vices1 z def9$ by !        
,secret>y4  4  7b7 ,no application (    
co9surance or d$uctible "u "p ,b  7#a7  
,am\nt ,section #ahcc7;a77#a7 ( !       

,social ,security ,act 7#db ,u4,s4,c4   
#aciel7a77#a77 is am5d$-- 7,a7 9        
subp>agraph 7,,gg71 by /rik+ & at ! end2
 &  7,b7 9 subp>agraph 7,,hh71 by /rik+ 
! semicolon at ! end & ins]t+ ! foll[+3 
& 7,,ii7 ) respect to advance c>e plann+
 s]vices 7z def9$ 9 section #ahfa7nnn77 
furni%$ on or aft] ,janu>y #a1 #bjbf1 ! 
am\nts paid %all be #ajj p]c5t ( ! less]
 ( ! actual *>ge = ! s]vices or ! am\nt 
det]m9$ "u ! fee s*$ule e/abli%$ "u     
section #ahdh7;b74  7#b7 ,waiv] (       
application ( d$uctible ,! fir/ s5t5ce (
 section #ahcc7;b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciel7b77 is      
am5d$-- 7,a7 by /rik+ 1 & 7#ac7 & ins]t+
 7#ac72 &  7,b7 by /rik+ section        
#ahfa7n74 & ins]t+ ! foll[+3 section    
#ahfa7n71 & 7#ad7 su* d$uctible %all n  
apply ) respect to advance c>e plann+   
s]vices 7z def9$ 9 section #ahfa7nnn77  
furni%$ on or aft] ,janu>y #a1 #bjbf4   
7c7 ,effective date ,! am5dm5ts made by 
?is section %all apply to items &       
s]vices furni%$ on or aft] ,janu>y #a1  

#bjbf4  #c4 ,,hhs provid] outrea*  7a7  
,outrea* ,! ,secret>y ( ,heal? & ,human 
,s]vices 79 ?is section ref]r$ to z !   
,secret>y7 %all conduct outrea* to      
physicians & appropriate non-physician  
practition]s p>ticipat+ "u ! ,m$ic>e    
program "u title ,,xviii ( ! ,social    
,security ,act ) respect to ,m$ic>e     
paym5t = advance c>e plann+ c\nsel+     
s]vices furni%$ to individuals to       
discuss _! heal? c>e pref]5ces1 id5tifi$
 by ,heal?c>e ,common ,proc$ure ,cod+   
,sy/em 7,,hcpcs7 codes #iidig & #iidih  
7or any successor to su* codes74 ,su*   
outrea* %all include a new1             
compreh5sive1 "o-"t education initiative
 to in=m su* physicians & practition]s (
 ! addition ( su* s]vices z a cov]$     
b5efit "u ! ,m$ic>e program1 includ+ !  
requirem5ts = eligibility = su* s]vices4
  7b7 ,report ,n lat] ?an #a ye> aft] ! 
date ( enactm5t ( ?is ,act1 ! ,secret>y 
%all submit to ! ,committee on ,ways &  
,means & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives & !

 ,committee on ,f9ance ( ! ,s5ate a     
report on ! outrea* conduct$ "u         
subsection 7a74 ,su* report %all include
 a description ( ! me?ods us$ = su*     
outrea*4  #d4 ,med,p,a,c report on !    
furni%+ ( advance c>e plann+ s]vices & !
 use ( advance c>e plann+ codes "u !    
,m$ic>e program  7a7 ,/udy ,! ,m$ic>e   
,paym5t ,advisory ,commission 79 ?is    
section ref]r$ to z ! ,commission7 %all 
conduct a /udy on advance c>e plann+ "u 
! ,m$ic>e program "u title ,,xviii ( !  
,social ,security ,act4 ,su* /udy %all  
include an analysis (-- 7#a7 ! furni%+ (
 advance c>e plann+ s]vices to ,m$ic>e  
b5efici>ies1 includ+-- 7,a7 :i* provid]s
 are tra9$ to provide su* s]vices2  7,b7
 :i* provid]s are eligible to provide   
su* s]vices "u ! ,m$ic>e program2  7,c7 
! l5g? & frequ5cy ( ! visits = furni%+  
su* s]vices2 &  7,d7 any b>ri]s relat$  
to provid]s furni%+1 or b5efici>ies be+ 
furni%$1 su* s]vices2  7#b7 ! use (     
advance c>e plann+ ,curr5t ,proc$ural   
,t]m9ology 7,,cpt7 codes to bill = !    

furni%+ ( advance c>e plann+ s]vices to 
,m$ic>e b5efici>ies1 includ+-- 7,a7     
circum/ances "u :i* codes o!r ?an       
advance c>e plann+ ,,cpt codes are us$  
to bill = su* s]vices "u ! ,m$ic>e      
program & :y provid]s d n use advance   
c>e plann+ ,,cpt codes2 &  7,b7 any     
b>ri]s to provid]s us+ advance c>e      
plann+ ,,cpt codes to bill = su* s]vices
 "u ! ,m$ic>e program2 &  7#c7 su* o!r  
items det]m9$ appropriate by !          
,commission4  7b7 ,report  7#a7 ,9 g5]al
 ,n lat] ?an ,june #cj1 #bjbf1 !        
,commission %all submit to ! ,committee 
on ,ways & ,means & ! ,committee on     
,en]gy & ,comm]ce ( ! ,h\se (           
,repres5tatives & ! ,committee on       
,f9ance ( ! ,s5ate a report on ! /udy   
conduct$ "u subsection 7a71 toge!r )    
recomm5dations = su* legislation &      
adm9i/rative action z ! ,commission     
det]m9es appropriate4