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Advanced Care Planning Services: Compliance With Medicare Requirements

In 2016, Medicare began paying for Advanced Care Planning (ACP), which is a face-to-face service through which a Medicare physician (or other qualified health care professional) and a patient discuss the patient's wishes for health care if he or she becomes unable to make decisions about care. It allows Medicare beneficiaries to make important decisions, giving them control over the type of care they receive and when they receive it. Previous reviews have shown improper payments due to a lack of clinical documentation to support face-to-face services, clinical documentation of the time spent discussing ACP, or both. We plan to perform a nationwide audit to determine whether Medicare providers for ACP services complied with Federal regulations.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare and Medicaid Services Advanced Care Planning Services: Compliance With Medicare Requirements Office of Audit Services W-00-20-35848;