Collins, Warner Introduce Bipartisan, Bicameral Legislation to Expand Access to Advance Care Planning

Press Release

U.S. Senators Susan Collins (R-ME) and Mark R. Warner (D-VA) introduced bipartisan, bicameral legislation to expand access to critical advance care planning (ACP) services in Medicare that allow people, especially those with serious illness, to plan for their care and have their choices honored when it matters most. The Improving Access to Advance Care Planning Act would help more Americans access critical advance care planning services by allowing social workers to provide advance care planning services, removing beneficiary cost-sharing, and promoting increased education for providers on current advance care planning codes, and improved reporting on barriers to providing advance care planning services and billing the corresponding codes. Companion legislation was introduced in the U.S. House of Representatives by Congressman Earl Blumenauer (D-OR).

"Unfortunately, most patients do not routinely make advance plans for their care in the event that they are diagnosed with a serious or life-threatening illness. This can be a difficult topic for many families to address, but advance care planning has been shown to increase satisfaction and improve health outcomes because people with advance directives are more likely to get the care they want, in the setting they prefer, and avoid the care that they don't want," said Senator Collins. "The bipartisan bill we are introducing today would help provide an opportunity for patients to have a structured discussion with their health care providers about their goals and treatment options so that they can make their choices known and develop a plan of care in consultation with their loved ones."

"Decisions about care planning are some of the hardest for a family to make, but they're also some of the most important. One of my biggest regrets was not having early conversations about care planning with my own mom, who suffered from Alzheimer's for 11 years and was unable to speak for nine of those years," said Senator Warner. "I'm proud to introduce this bill because folks with a serious illness deserve to have a say over what their care should look like, and families deserve the certainty of knowing they are honoring their loved ones' wishes."

Specifically, this legislation would codify Medicare coverage of advance care planning services. The bill would also expand eligible providers that can bill for such services to include clinical social workers with experience in care planning. Additionally, it would remove beneficiary coinsurance and deductibles for advance care planning visits -- including those that happen outside of an annual Medicare Annual Wellness Visit -- to ensure that beneficiaries are not deterred from seeking these services, and providers are not deterred from offering them. The bill would also require two reports: one that directs CMS to educate providers on the advance care planning codes and report to Congress on such activities, and one that directs MedPAC to study and report to Congress on (A) barriers to providing and receiving advance care planning services despite the ability to bill for them, and (B) barriers to billing the code itself.

Senators Collins and Warner were joined in introducing this legislation in the Senate by Senators Tammy Baldwin (D-WI) and Amy Klobuchar (D-MN).

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