Crucial Decisions on End-of-Life Medical Care Could Be Made In Consultation with Doctors In Advance of Incapacitation

Press Release 12/17/15

TRENTON – The crucial decisions about end-of-life medical care made in advance of incapacitating conditions would be supported by Medicaid, according to legislation sponsored by Senator Richard J. Codey and Senator Joseph F. Vitale. The bill, S-2435, requiring Medicaid reimbursement for advance care planning consultations with doctors or other caregivers, was approved by the Senate today.

“As New Jersey residents age, they should be able to have conversations with their trusted health care providers about their future health care wishes should they become unable to make their own decisions in the future due to incapacity,” said Senator Codey (D-Essex, Morris). “Those advance medical directives should be supported by Medicaid to make sure the elderly and terminally ill are cared for with dignity and according to their own wishes.”

Advance care planning is the practice of preparing explicit written instructions for caregivers, family and friends on the type of care that should be provided or withheld, including palliative care, in case of incapacitation.

“Such planning is important to the elderly and terminally ill because it allows them to maintain control over their own health care decisions even after they are unable to communicate these decisions at a future date,” said Senator Vitale (D-Middlesex). “Making those decisions with the help of medical professionals before it’s too late is equally important and our Medicaid system should reimburse for this practice.”

The American Medical Association recently recommended that Medicare provide reimbursement for the practice. The Medicare statute currently provides coverage for advance care planning under the “Welcome to Medicare” visit available to all Medicare beneficiaries, but they may not need these services when they first enroll. Starting in 2016, Medicare will begin covering advance care planning as a separate and billable service.

Two states, Colorado and Oregon, have already moved forward on similar legislation by approving Medicaid payments for the consultative care.

Once the government-sponsored programs adopt this change, it would set a standard for private insurers and encourage more doctors to engage in these conversations with their patients, Senator Codey pointed out.

“Coverage would raise awareness of this valuable service, and allow residents to make decisions with greater comfort on end-of-life care,” said Senator Codey.

The bill cleared the Senate with a vote of 29-8. It cleared the Assembly with a vote of 46-13 and now heads to the Governor’s desk for consideration.