Health care providers have been strong proponents of reimbursing physicians for discussion with patients about advance care planning, which would include end-of-life decisions. In a proposed rule released yesterday, the Centers for Medicare & Medicaid Services suggested that Medicare do just that.  

Groups backing the proposal have included the American Hospital Association, the American College of Physicians and the American Medical Association — which reignited the discussion on the issue by including two related reimbursement codes in its physician payment recommendations last year.

The issue has been controversial after it became intertwined in the “death panel” debates over the creation of the Independent Payment Advisory Board by the Affordable Care Act. “This issue has been mischaracterized in the past and it is time to facilitate patient choices about advance care planning decisions,” said Andrew Gurman, M.D., president-elect of the AMA, in a statement.

But more recently, the Institute of Medicine and author Atul Gawande, M.D., have given the concept their backing and perhaps spurred broader support. The IOM issued a a 506-page report, "Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life," while Gawande has gotten attention for his book, “Being Mortal.”

Comment on the proposed rule is being accepted by CMS through Sept. 8.