CMS Pub. 100-16, ch. mc86c17f, § 130.4

Obligations

(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)

The written information provided to enrollees must, at a minimum, include a description

of the Medicare cost plan’s written policies on advance directives including an

explanation of the following:

• That the organization cannot refuse care or otherwise discriminate against an

individual based on whether or not the individual has executed an advance

directive;

• The right to file a complaint about an organization’s noncompliance with advance

directive requirements, and where to file the complaint;

• That the plan must document in a prominent part of the individual’s current

medical record whether or not the individual has executed an advance directive;

• That the Medicare cost plan is required to comply with State law;

• That the Medicare cost plan must educate its staff about its policies and

procedures for advance directives; and

• That the Medicare cost plan must provide for community education regarding

advance directives.

If the Medicare cost plan cannot implement an advance directive as a matter of

conscience, it must issue a clear and precise written statement of this limitation. The

statement must include information that:

• Explains the differences between institution-wide objections based on conscience

and those that may be raised by individual physicians;

• Identifies the state legal authority permitting such objection; and

• Describes the range of medical conditions or procedures affected by the

conscience objection.