Sec. 6. Improvement of policies related to the use and portability of advance directives
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/bill/114/s/1549/is/section-6A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1866(f) of the Social Security Act ( 42 U.S.C. 1395cc(f) ) is amended— in paragraph (1)— in subparagraph (A)(i)— by inserting relevant after rights under ; and by striking of the State ; by striking subparagraph (B); by redesignating subparagraphs (C), (D), and
(E)as subparagraphs (G), (H), and (I), respectively; by inserting after subparagraph
(A)the following new subparagraphs: to request and document in a prominent part of the individual's current medical record the content of (or a copy of) an advance directive or portable treatment order; to provide each individual with resources to assist them in understanding the information provided to them pursuant to subparagraph (A); in the case of an individual with decisional capacity under State law, to follow the individual’s current treatment instructions, as expressed in writing or through verbal or non-verbal communications; in the case of an individual who lacks decisional capacity— to follow treatment decisions in accordance with current advance directives and portable treatment orders that are valid under State law where the care is delivered and the instructions provided by legally authorized representatives in accordance with State law; and in the absence of a current advance directive or portable treatment order that is valid under State law where the care is delivered or instructions provided by a legally authorized representative in accordance with State law, to deliver treatment based on credible evidence of the individual’s treatment preferences, goals, and values, which evidence may include a current advance directive or portable treatment order executed in another State; that specify conditions or circumstances under which an advance directive, portable treatment order, or treatment directions from an individual or legally authorized representative would not be followed; ; in subparagraph (H), as redesignated by subparagraph (C), by striking State law and all that follows through respecting and inserting this section and relevant State and Federal law respecting ; in subparagraph (I), as redesignated by subparagraph (C), by inserting and portable treatment orders before the period at the end; in the flush matter at the end, by striking
(C)and inserting
(G); and by adding at the end the following new sentence: Nothing in subparagraph
(D)or
(E)shall be construed to apply to a request or directive ordering a sterilization or abortion or ordering withdrawal of treatment from a pregnant woman if continued treatment can reasonably be expected to bring her child to live birth. ; by redesignating paragraphs
(3)and
(4)as paragraphs
(4)and (5), respectively; by inserting after paragraph
(2)the following new paragraph: Nothing in this section shall be construed to prohibit the application of a State law which allows for an objection on the basis of conscience for any health care provider or any agent of such provider which as a matter of conscience cannot implement an advance directive or portable treatment order. ; in paragraph (4), as redesignated by paragraph (2)— by striking a written and inserting an ; by striking State law and inserting State or Federal law ; and by striking of the State ; by redesignating paragraph (5), as redesignated by paragraph (2), as paragraph (6); by inserting after paragraph
(4)the following new paragraph: In this subsection, the term portable treatment order means a treatment order designed to document a clinical process that includes shared, informed medical decisionmaking, that reflects the individual’s goals of care and values, and that is designed to apply across care settings, including the home. ; and by inserting after paragraph (6), as redesignated by paragraph (6), the following new paragraph: Nothing in this subsection shall permit the Secretary to seek civil penalties, including exclusion from participation in the program under this title or the program under title XIX, against a provider or organization if the provider or organization— used reasonable efforts to deliver care that is consistent with an individual's goals, preferences, and values when addressing decisionmaking for an individual who lacks decisional capacity; or exercised its right of conscience in accordance with paragraph (3). . The amendments made by paragraph
(1)shall apply to provider agreements and contracts entered into, renewed, or extended under title XVIII of the Social Security Act on or after such date as the Secretary of Health and Human Services specifies, but in no case may such date be later than 1 year after the date of the enactment of this Act. Nothing in the provisions of, or the amendments made by, this subsection shall be construed to require a provider of services or an organization to act in a manner contrary to its religious or moral convictions. Paragraph
(2)of section 7 of the Assisted Suicide Funding Restriction Act of 1997 ( 42 U.S.C. 14406 ) is amended to read as follows: to require any provider or organization, or any employee of such a provider or organization, to follow or be bound by a request from an individual or legally authorized representative, an advance directive, or a portable treatment order that directs the purposeful causing of, or the purposeful assisting in causing, the death of any individuals, such as by assisted suicide, euthanasia, or mercy killing. .
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Sec. 6
Improvement of policies related to the use and portability of advance directives
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