Obama Administration Reverses Regulation on End-of-Life Counseling

On Tuesday, Obama administration officials said that an end-of-life counseling provision, which took effect on Jan. 1, will be removed from a new Medicare regulation because of procedural reasons, the New York Times reports.

The provision for so-called advance care planning, including discussions about end-of-life treatment, initially was included in health reform legislation but was dropped after it incited broad Republican-led criticism that it would establish "death panels."

However, Medicare regulations published in the Federal Register in November 2010 that set reimbursement rates for physician services included language saying that end-of-life planning was covered as part of regular physical examinations, the Times reports.

Basis for Decision

According to the Times, the proposed rule did not include the language when it was published for public comment in July 2010. On Tuesday, an Obama administration official said, "We realize that [the provision's language] should have been included in the proposed rule so more people could have commented on it specifically," adding, "This [change] should not affect beneficiaries' ability to have these voluntary conversations with their doctors."

According to the Times, it is "clear that political concerns were also a factor" in the administration's decision to remove the reference to end-of-life care, particularly to head off the potential for the new House Republican majority to use it as a reason to repeal the reform law.

The decision, however, has upset some HHS officials who say that discussions about end-of-life care between patients and their doctors should be promoted to help ensure that the patients receive the care they want (Pear, New York Times, 1/4).