United States. Congress

“ In the case of any individual who is a covered beneficiary (as defined in section 1072 (5) of title 10, United States Code) at the time the individual is entitled to hospital insurance benefits under part A under section 226 (b) or section 226A and who is eligible to enroll but who has elected not to enroll (or to be deemed enrolled) during the individual’s initial enrollment period, there shall be a special enrollment period described in paragraph (2) . ”

“ A practitioner described in this paragraph is— `` (A) a physician (as defined in subsection (r) (1) ) ; and `` (B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments. `` (3) (A) An initial preventive physical examination under subsection (WW) , including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1) . ”

“ Demonstration Program on Use of Patient Decisions Aids. (a) In General.— The Secretary of Health and Human Services shall establish a shared decision making demonstration program (in this subsection referred to as the ``program ́ ́) under the Medicare program using patient decision aids to meet the objective of improving the understanding by Medicare beneficiaries of their medical treatment options, as compared to comparable Medicare beneficiaries who do not participate in a shared decision making process using patient decision aids. ”

“ The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965) . `` (E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title. ”

“ Extension of Secondary Payer Requirements for ESRD Beneficiaries.— Section 1862 (b) (1) (C) of such Act (42 U.S.C. 1395y (b) (1) (C) ) is amended by adding at the end the following new sentence: ``With regard to immunosuppressive drugs furnished on or after the date of the enactment of the America’s Affordable Health Choices Act of 2009, this subparagraph shall be applied without regard to any time limitation. ”

“ The provision of such drugs shall be subject to the application of— `` (i) the deductible under section 1833 (b) ; and `` (ii) the coinsurance amount applicable for such drugs (as determined under this part) . ”