A bipartisan bill set to be introduced on Tuesday would pay seniors $75 to put together a living will that lays out a patient’s wishes on medical treatment to doctors and family members should they become incapacitated.
The bill, provided exclusively to the Washington Examiner, is aimed at getting seniors to talk with family members about how to deal with end-of-life issues, according to a Senate aide familiar with the bill. The problem today is that many family members don’t talk about these issues until it’s too late.
“This is a difficult thing we want patients to think about,” the aide said.
If the bill becomes law, the Centers for Medicare and Medicaid Services would pay Medicare beneficiaries a one-time payment of $75 if they completed a living will, which is also known as an advance directive and lays out wishes for medical treatment if the patient can’t speak for themselves. The program would be completely voluntary.
To get the money, the beneficiary would have to certify to CMS that it created an electronic advance directive at any time. The directive can be canceled or changed at any time, but paper versions of advance directives would not be accepted.
CMS wouldn’t hold a database of the documents, but instead require that the federal government certify vendors that sell the electronic directives. A Medicare beneficiary who gets a directive from a certified vendor could voluntarily notify CMS and register to get the $75.
The bill keeps in place all state laws governing what must be included in an advance directive.
The funding for the $75 payments would come from Medicare’s trust fund. The Congressional Budget Office has not yet had a chance to produce a score describing how much the incentive program would cost and the impact on the federal deficit.
However, a 2015 study by the healthcare consulting firm Avalere found that a one-time incentive could have reduced federal spending by $13.8 billion from 2015 to 2024. While the incentive could cost $7.2 billion, it would be offset by an estimated $21 billion in savings from reduced end-of-life Medicare spending.
The costs associated with an advance directive for a person vary from a small fee to notarize the document to higher costs for an attorney to review it.
The bill has bipartisan support in both the House and the Senate.
Sens. Chris Coons, D-Del.; Michael Bennet, D-Colo.; Bill Cassidy, R-La.; and John Barrasso, R-Wyo., are supporting it in the Senate. Reps. Peter Welch, D-Vt., Mike Thompson, D-Calif., Diane Black, R-Tenn., and Chris Collins, R-Ny., are sponsoring it in the House.
The bill has support from key groups, including the anti-abortion group National Right to Life, the nonprofit hospice care group National Partnership for Hospice Innovation, American Nurses Association, Third Way and the Coalition to Transform Advanced Care, which is a nonprofit that addresses issues surrounding patients with advanced illnesses.
