And here are instructions for commenting.
FEDERAL REGS COMMENT DEADLINE IS
SEPT 8 AT 5PM (Who needs legislation? Death Panels Back By Government
Fiat!)
September 3, 2015
Dear all,
It has been almost five years since I wrote you about
the effort of the federal government to impose EOL consultations on us through
the use of a carrot and stick.
That alert apparently made its way to the desk of Robert Pear
at the NY Times, their healthcare expert. He was interested in LifeTree's
investigative work and ran a story on Christmas Day titled "Obama
Returns to End-of-Life Plan That Caused Stir."
On January 4, 2011, the Obama administration withdrew the EOL
portion of the new regulation, just 10 days after the NY Times article. The
story had captured the news over the holidays.
Since then the Big Death lobby, a.k.a. the Third Path
Movement, has been patiently at work getting ready to come at this problem
again!
A "Notice and Comment Rulemaking" period is currently under
way with a deadline of September 8, 2015, 5pm Eastern. After that deadline next
Tuesday, an important change in how medicine will be practiced will take place
unless CMS (Centers for Medicare and Medicaid Services) receives serious
negative comments from the general public.
Here is what has happened. Please continue to read. This is
important!!
Two new CPT Codes
(Current Procedural Terminology Codes, registered trademard of the American
Medical Association) can be used by healthcare professionals starting Jan 1,
2016 to record Advance Care Planning Services and apply for reimbursement from
the federal government for these "services."
These Advance Care
Planning talks will record wishes pertaining to medical treatment and record
them in an advance care document such as 1) healthcare proxy, 2) healthcare
power of attorney, 3) living will and 4) POLST/MOST/POST/MOLST form. (You know,
the POLST form that become doctor's orders!)
These codes are 99497
for the first 30 minutes of advance care planning discussion and form completion
with the patient by the physician or other qualified health professional, and
99498 for any additional minutes spent with the patient for that
purpose.
PLEASE, take a moment right now to tell the federal
government that you oppose this regulatory change. (See the list of suggested points which you could make,
below)
You can submit comments
electronically, by regular mail, or by express or overnight mail. Use only one
method. Please comment
IMMEDIATELY.
_____________________________________________________________
1. By electronic
mail. Here are two direct links:
Info &
instructions:
Comment form:
2. By regular mail. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1631-P, P.O. Box 8013, Baltimore, MD 21244-8013.
NOTE: Please allow sufficient time for mailed comments to
be received before the close of the comment period which is Sept 8, 2015 at
5pm.
2. By express or
overnight mail. You may send written comments to the following address ONLY:
Centers for Medicare & Medicaid Services, Department of Health and Human
Services, Attention: CMS-1631-P, Mail Stop C4-26-05, 7500 Security Boulevard,
Baltimore, MD 21244-1850.
____________________________________________________________________
If the comment period goes according to the Big Death lobby's
hopes and aspirations these codes will become "active" which means that the new codes can start being used and
the government will start paying for these End-of-Life consulting "services" in
the near future. (Reference is in the Federal Register of Wednesday, July 15,
2015, Vol 80, No. 135, p. 41773)
Diane Meier of the Center to Advance Palliative Care is
crowing that this time the change is happening without any fanfare, without any
cries of death panels or media attention. WE NEED TO MAKE SOME
FANFARE!!!
At the end of this email are
suggested discussion points you can make in your individual letters. In
summary, expect these ACP talks to be conducted using a one-size-fits-all
framework of boxes to check which will become doctor's orders, the POLST
form!
Prayers to the Holy Spirit and to St. Joseph,
Elizabeth D. Wickham, PhD
PO Box 17301
Raleigh, NC, 27619
--------------------------------------------------------------------------------------------
Here are some suggested points
to make in your letter:
- These
2 codes (99497 and 99498) are not about paying for traditional medicine. They
encourage End-of-Life (EOL) discussions. Most doctors do not go to medical
school to learn how to conduct EOL discussions. These codes are for a new type
of medicine called palliative medicine. Palliative medicine is a vehicle of the
Right to Die movement to legitimize the hastening of
death.
- Use
of these 2 codes means that only EOL discussions occurred, not diagnosis or
curative treatment.
- These
two can be used over and over. This rule change will encourage those who are
trained to persuade the patient to choose life limiting choices to come back
again and again so long they don't "succeed." What right does the patient have
to say, "Go away!"
- These
Advance Care Planning (ACP) "talks" that are paid for by these 2 codes are
recommended for all adults, not just seniors. The culture of death wants to
bring death awareness into every fabric of healthcare.
- These
2 codes will pay for talks not only with physicians but also with "other qualified professionals." Who
are these "other qualified professionals"? It is not hard to figure this
out. The Affordable Care Act (Obamacare) funds training of POLST
"facilitators." High on that list of groups who funded by Obamacare are the
Respecting Choices conversation specialists who trained using a curriculum
developed by Bud Hammes in LaCross, WI. Respecting Choices professionals are
emerging members of the palliative care team.
- The
government will have the power to set quality measures for Advance Care Planning
"talks." Use of these 2 codes will imply use of a standardized approach to Advance Care
Planning. The conversation language will be to motivate the patient to
participate in the ACP "process" and to fill out the POLST
form.
- After
the advance care wishes are known and recorded (electronically) non-compliance
with those wishes will be considered a "safety issue" and will need to be
"investigated."
- The
long run plan for these 2 codes is to give government power to decide what
constitutes an "acceptable discussion" about EOL decisions. Doctors will be
penalized if they do not conform. Socialized medicine for
sure.
- Doctors
will be pressured to make their quota of patients with advance
directives.
- These
2 codes will override doctors who want to protect their patients. The
"facilitators", i.e. "other qualified
professionals", will quickly be given control over most of the ACP
talks.
- We
know already that some private insurers are paying for ACP talks. These 2 codes
will be supported by most private insurers because by paying for these
end-of-life discussions private insurance companies can cut the costs they might
have to spend later on for the sickest patients.
- These
2 codes will encourage the use of the POLST form across all states, even those
who do not have a developed POLST program. See the letter written by the
National POLST Paradigm Task Force to CMS about this rule change a couple weeks
ago here.
- With
access to Electronic Health Records, computers can be taught to recognize who
doesn't have an Advance Care Plan. Then comes the nurse manager to call you up
and offer a community healthcare worker to spend time with you and get paid
using these 2 codes.
- Having
the Advance Care Plan talk may cause moral distress for some providers,
clinicians and patients. After all, we are taught to make decisions about our
health care at the moment and with the knowledge that we are obligated to
preserve and protect our life which is a gift from God.
- The
Gunderson Health System has been training Respecting Choices (RC) facilitators
for decades. There are other "facilitators" being trained by community
organizations. Community Conversations on Compassionate Care (CCCC) offers
group discussions by trained lay and health professionals. Both RC and CCCC
define "success" in ACP talks as the choice to prevent unwanted life-sustaining
treatment.
In summary, Respecting Choices and Community Conversations on
Compassionate Care people will become clinical micro systems integrated into
routine care through these 2 codes to shape physician behavior.
No comments:
Post a Comment