Us Congress 2023-2024 Regular Session

Us Congress Senate Bill SB3 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	II
2	2	118THCONGRESS
3	3	2
4	4	DSESSION S. 3
5	5	To amend title XVIII of the Social Security Act to waive cost-sharing for
6	6	advance care planning services, and for other purposes.
7	7	IN THE SENATE OF THE UNITED STATES
8	8	DECEMBER20 (legislative day, DECEMBER16), 2024
9	9	Mr. W
10	10	ARNER(for himself, Ms. COLLINS, Ms. BALDWIN, and Ms. KLO-
11	11	BUCHAR) introduced the following bill; which was read twice and referred
12	12	to the Committee on Finance
13	13	A BILL
14	14	To amend title XVIII of the Social Security Act to waive
15	15	cost-sharing for advance care planning services, and for
16	16	other purposes.
17	17	Be it enacted by the Senate and House of Representa-1
18	18	tives of the United States of America in Congress assembled, 2
19	19	SECTION 1. SHORT TITLE. 3
20	20	This Act may be cited as the ‘‘Improving Access to 4
21	21	Advance Care Planning Act’’. 5
22	22	SEC. 2. MEDICARE COVERAGE OF ADVANCE CARE PLAN-6
23	23	NING SERVICES. 7
24	24	(a) A
25	25	DVANCECAREPLANNINGSERVICESDE-8
26	26	FINED.—Section 1861 of the Social Security Act (42 9
27	27	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3.IS S3
28	28	ssavage on LAPJG3WLY3PROD with BILLS 2
29	29	•S 3 IS
30	30	U.S.C. 1395x) is amended by adding at the end the fol-1
31	31	lowing new subsection: 2
32	32	‘‘(nnn) A
33	33	DVANCECAREPLANNINGSERVICES.— 3
34	34	‘‘(1) I
35	35	N GENERAL.—The term ‘advance care 4
36	36	planning services’ means a visit between an eligible 5
37	37	practitioner (as defined in paragraph (2)) enrolled 6
38	38	under section 1866(j) and an individual, a family 7
39	39	member of such individual, or a surrogate des-8
40	40	ignated by such individual, to discuss— 9
41	41	‘‘(A) the health care preferences of such 10
42	42	individual; 11
43	43	‘‘(B) future health care decisions that may 12
44	44	need to be made by, or on behalf of, such indi-13
45	45	vidual; and 14
46	46	‘‘(C) advance directives or other standard 15
47	47	forms, which may be completed by, or on behalf 16
48	48	of, such individual. 17
49	49	‘‘(2) E
50	50	LIGIBLE PRACTITIONER.—For purposes 18
51	51	of paragraph (1), the term ‘eligible practitioner’ 19
52	52	means— 20
53	53	‘‘(A) a physician (as defined in subsection 21
54	54	(r)); 22
55	55	‘‘(B) a physician assistant (as defined in 23
56	56	subsection (aa)(5)); 24
57	57	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3.IS S3
58	58	ssavage on LAPJG3WLY3PROD with BILLS 3
59	59	•S 3 IS
60	60	‘‘(C) a nurse practitioner (as defined in 1
61	61	subsection (aa)(5)); 2
62	62	‘‘(D) a clinical nurse specialist (as defined 3
63	63	in subsection (aa)(5)); or 4
64	64	‘‘(E) a clinical social worker (as defined in 5
65	65	subsection (hh)(1)) who possesses— 6
66	66	‘‘(i) a relevant care planning certifi-7
67	67	cation; or 8
68	68	‘‘(ii) experience providing care plan-9
69	69	ning conversations or similar services, as 10
70	70	defined by the Secretary.’’. 11
71	71	(b) N
72	72	OAPPLICATION OFCOINSURANCE ORDEDUCT-12
73	73	IBLEUNDERPARTB.— 13
74	74	(1) A
75	75	MOUNT.—Section 1833(a)(1) of the Social 14
76	76	Security Act (42 U.S.C. 1395l(a)(1)) is amended— 15
77	77	(A) in subparagraph (GG), by striking 16
78	78	‘‘and’’ at the end; and 17
79	79	(B) in subparagraph (HH), by striking the 18
80	80	semicolon at the end and inserting the fol-19
81	81	lowing: ‘‘and (II) with respect to advance care 20
82	82	planning services (as defined in section 21
83	83	1861(nnn)) furnished on or after January 1, 22
84	84	2026, the amounts paid shall be 100 percent of 23
85	85	the lesser of the actual charge for the services 24
86	86	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3.IS S3
87	87	ssavage on LAPJG3WLY3PROD with BILLS 4
88	88	•S 3 IS
89	89	or the amount determined under the fee sched-1
90	90	ule established under section 1848(b)’’. 2
91	91	(2) W
92	92	AIVER OF APPLICATION OF DEDUCT -3
93	93	IBLE.—The first sentence of section 1833(b) of the 4
94	94	Social Security Act (42 U.S.C. 1395l(b)) is amend-5
95	95	ed— 6
96	96	(A) by striking ‘‘, and (13)’’ and inserting 7
97	97	‘‘(13)’’; and 8
98	98	(B) by striking ‘‘section 1861(n).’’ and in-9
99	99	serting the following: ‘‘section 1861(n), and 10
100	100	(14) such deductible shall not apply with re-11
101	101	spect to advance care planning services (as de-12
102	102	fined in section 1861(nnn)) furnished on or 13
103	103	after January 1, 2026’’. 14
104	104	(c) E
105	105	FFECTIVEDATE.—The amendments made by 15
106	106	this section shall apply to items and services furnished on 16
107	107	or after January 1, 2026. 17
108	108	SEC. 3. HHS PROVIDER OUTREACH. 18
109	109	(a) O
110	110	UTREACH.—The Secretary of Health and 19
111	111	Human Services (in this section referred to as the ‘‘Sec-20
112	112	retary’’) shall conduct outreach to physicians and appro-21
113	113	priate non-physician practitioners participating under the 22
114	114	Medicare program under title XVIII of the Social Security 23
115	115	Act with respect to Medicare payment for advance care 24
116	116	planning counseling services furnished to individuals to 25
117	117	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3.IS S3
118	118	ssavage on LAPJG3WLY3PROD with BILLS 5
119	119	•S 3 IS
120	120	discuss their health care preferences, identified by 1
121	121	Healthcare Common Procedure Coding System (HCPCS) 2
122	122	codes 99497 and 99498 (or any successor to such codes). 3
123	123	Such outreach shall include a new, comprehensive, one- 4
124	124	time education initiative to inform such physicians and 5
125	125	practitioners of the addition of such services as a covered 6
126	126	benefit under the Medicare program, including the re-7
127	127	quirements for eligibility for such services. 8
128	128	(b) R
129	129	EPORT.—Not later than 1 year after the date 9
130	130	of enactment of this Act, the Secretary shall submit to 10
131	131	the Committee on Ways and Means and the Committee 11
132	132	on Energy and Commerce of the House of Representatives 12
133	133	and the Committee on Finance of the Senate a report on 13
134	134	the outreach conducted under subsection (a). Such report 14
135	135	shall include a description of the methods used for such 15
136	136	outreach. 16
137	137	SEC. 4. MEDPAC REPORT ON THE FURNISHING OF AD-17
138	138	VANCE CARE PLANNING SERVICES AND THE 18
139	139	USE OF ADVANCE CARE PLANNING CODES 19
140	140	UNDER THE MEDICARE PROGRAM. 20
141	141	(a) S
142	142	TUDY.—The Medicare Payment Advisory Com-21
143	143	mission (in this section referred to as the ‘‘Commission’’) 22
144	144	shall conduct a study on advance care planning under the 23
145	145	Medicare program under title XVIII of the Social Security 24
146	146	Act. Such study shall include an analysis of— 25
147	147	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3.IS S3
148	148	ssavage on LAPJG3WLY3PROD with BILLS 6
149	149	•S 3 IS
150	150	(1) the furnishing of advance care planning 1
151	151	services to Medicare beneficiaries, including— 2
152	152	(A) which providers are trained to provide 3
153	153	such services; 4
154	154	(B) which providers are eligible to provide 5
155	155	such services under the Medicare program; 6
156	156	(C) the length and frequency of the visits 7
157	157	for furnishing such services; and 8
158	158	(D) any barriers related to providers fur-9
159	159	nishing, or beneficiaries being furnished, such 10
160	160	services; 11
161	161	(2) the use of advance care planning Current 12
162	162	Procedural Terminology (CPT) codes to bill for the 13
163	163	furnishing of advance care planning services to 14
164	164	Medicare beneficiaries, including— 15
165	165	(A) circumstances under which codes other 16
166	166	than advance care planning CPT codes are used 17
167	167	to bill for such services under the Medicare pro-18
168	168	gram and why providers do not use advance 19
169	169	care planning CPT codes; and 20
170	170	(B) any barriers to providers using ad-21
171	171	vance care planning CPT codes to bill for such 22
172	172	services under the Medicare program; and 23
173	173	(3) such other items determined appropriate by 24
174	174	the Commission. 25
175	175	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3.IS S3
176	176	ssavage on LAPJG3WLY3PROD with BILLS 7
177	177	•S 3 IS
178	178	(b) REPORT.— 1
179	179	(1) I
180	180	N GENERAL.—Not later than June 30, 2
181	181	2026, the Commission shall submit to the Com-3
182	182	mittee on Ways and Means and the Committee on 4
183	183	Energy and Commerce of the House of Representa-5
184	184	tives and the Committee on Finance of the Senate 6
185	185	a report on the study conducted under subsection 7
186	186	(a), together with recommendations for such legisla-8
187	187	tion and administrative action as the Commission 9
188	188	determines appropriate. 10
189	189	Æ
190	190	VerDate Sep 11 2014 18:05 Jan 23, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S3.IS S3
191	191	ssavage on LAPJG3WLY3PROD with BILLS