Somebody please explain Medicare end-of-life planning flip-flop

In the NY Times, Robert Pear takes a stab:

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1. […]

Although the health care bill signed into law in March did not mention end-of-life planning, the topic was included in a huge Medicare regulation setting payment rates for thousands of physician services. The final regulation was published in the Federal Register in late November. The proposed rule, published for public comment in July, did not include advance care planning.

An administration official, authorized by the White House to explain the mix-up, said Tuesday, “We realize that this should have been included in the proposed rule, so more people could have commented on it specifically.”

“We will amend the regulation to take out voluntary advance care planning,” the official said. “This should not affect beneficiaries’ ability to have these voluntary conversations with their doctors.”

Huh? Did the Administration follow proper procedure or not? If so, what are they doing? It looks like they don’t even know. If they didn’t follow proper procedure, that looks pretty bad too. Either way, I’m not satisfied with what’s going on. Can someone explain this better? There has got to be more to it.

UPDATE: See also Don Taylor’s take.

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