,,ii #aai? ,,congress #a/ ,session ,s4 #bhfe ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,septemb] #ah 7legislative day1 ,septemb] #af71 #bjbe ,mr4 ,w>n] 7= himself & ,ms4 ,coll9s7 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 s]vices provid$ by an eligible practition] 7z def9$ 9 p>agraph 7#b77 to an individual1 a family memb] ( su* individual1 a c>egiv] ( su* individual1 or su* individual's repres5tative1 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 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>y2 or 7,f7 any o!r practition] det]m9$ appropriate by ! ,secret>y4 4 7b7 ,enc\rag+ advance c>e plann+ 7#a7 ,paym5t ,section #ahdh7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#ac7 ,enc\rag+ advance c>e plann+ s]vices 7,a7 ,9 g5]al ,9 ord] to enc\rage advance c>e plann+ s]vices1 ! ,secret>y %all1 subject to subp>agraph 7,b71 make paym5ts 7z ! ,secret>y det]m9es to be appropriate7 "u ?is section = advance c>e plann+ s]vices 7z def9$ 9 section #ahfa7nnn77 furni%$ on or aft] ! date ( enactm5t ( ?is p>agraph4 7,b7 ,policies relat$ to paym5t ,9 c>ry+ out ?is p>agraph1 ) respect to advance c>e plann+ s]vices1 ! ,secret>y-- 7i7 %all make paym5t to only #a applicable provid] = su* s]vices furni%$ to an individual dur+ a p]iod2 7ii7 %all n make a paym5t "u subp>agraph 7,a7 if su* paym5t w\ld be duplicative ( a paym5t t is o!rwise made "u ?is title = su* s]vices2 & 7iii7 %all n require t an annual wellness visit 7z def9$ 9 section #ahfa7;hhh77 or an initial prev5tive physical exam9ation 7z def9$ 9 section #ahfa7ww77 be furni%$ z a condition ( paym5t = su* s]vices4 4 7#b7 ,remov+ co/-%>+ responsibilities = advance c>e plann+ s]vices "u "p ,b ( ! ,m$ic>e program ,section #ahcc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciel7 is am5d$-- 7,a7 9 subsection 7a77#a7-- 7i7 9 subp>agraph 7,,gg71 by /rik+ & at ! end2 & 7ii7 9 subp>agraph 7,,hh71 by /rik+ ! semicolon at ! end & ins]t+ ! foll[+3 1 & 7,,ii7 ) respect to advance c>e plann+ s]vices 7z describ$ 9 section #ahdh7;b77#ac77 furni%$ on or aft] ,janu>y #a1 #bjbg1 ! am\nt paid %all be an am\nt equal to #ajj p]c5t ( ! less] ( ! actual *>ge = su* s]vices or ! am\nt det]m9$ "u su* section2 & 7,b7 9 subsection 7b71 9 ! fir/ s5t5ce-- 7i7 by /rik+ 1 & 7#ac7 & ins]t+ 7#ac72 & 7ii7 by /rik+ section #ahfa7n74 & ins]t+ ! foll[+3 section #ahfa7n71 & 7#ad7 su* d$uctible %all n apply ) respect to advance c>e plann+ s]vices 7z describ$ 9 section #ahdh7;b77#ac77 furni%$ on or aft] ,janu>y #a1 #bjbg4 7c7 ,improvem5ts ,to advance c>e plann+ ?r\gh teleheal? ,section #ahcd7m7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is am5d$-- 7#a7 9 p>agraph 7#d77;,c7-- 7,a7 9 clause 7i71 9 ! matt] prec$+ subclause 7,i71 by /rik+ & 7#g7 & ins]t+ 7#g71 & 7#aj72 & 7,b7 9 clause 7ii77,x71 by ins]t+ or p>agraph 7#aj7 be=e ! p]iod at ! end2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#aj7 ,treatm5t ( advance c>e plann+ s]vices ,! geographic requirem5ts describ$ 9 p>agraph 7#d77;,c77i7 %all n apply ) respect to teleheal? s]vices furni%$ on or aft] ! date ( enactm5t ( ?is p>agraph = purposes ( furni%+ advance c>e plann+ s]vices 7z def9$ 9 section #ahfa7nnn774 4 7d7 ,align+ def9itions ,section #ahfa ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is am5d$-- 7#a7 9 subsection 7ww7-- 7,a7 9 p>agraph 7#a71 by /rik+ end-(-life plann+ 7z def9$ 9 p>agraph 7#c77 & ins]t+ advance c>e plann+ 7z def9$ 9 subsection 7nnn772 & 7,b7 by /rik+ p>agraph 7#c72 & 7#b7 9 subsection 7hhh77#b7-- 7,a7 by r$esignat+ subp>agraph 7,i7 z subp>agraph 7,j72 7,b7 by r$esignat+ subp>agraph 7,i7 z subp>agraph 7,j72 & 7,c7 by ins]t+ aft] subp>agraph 7,h7 ! foll[+ new subp>agraph3 7,i7 ,advance c>e plann+ s]vices 7z def9$ 9 subsection 7nnn774 4 #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+ 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$ic>e program1 includ+ ! requirem5ts = b5efici>y eligibility = su* s]vices4 7b7 ,report ,n lat] ?an #a ye> aft] ! date ( completion ( ! outrea* describ$ 9 subsection 7a71 ! ,secret>y %all submit to ! ,committee on ,f9ance ( ! ,s5ate & ! ,committee on ,ways & ,means & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives 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 ,n lat] ?an ,june #cj1 #bjbg1 ! ,commission %all submit to ! ,committee on ,f9ance ( ! ,s5ate & ! ,committee on ,ways & ,means & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives a report on ! /udy conduct$ "u subsection 7a71 toge!r ) recomm5dations = su* legislation & adm9i/rative action z ! ,commission det]m9es appropriate4