MAP for Care Act
- Bill Number
- S. 3473
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-12-15: Read twice and referred to the Committee on Finance.
- Last Updated
- 2026-04-21T17:49:54Z
AI-Generated Summary
Purpose
The Medicare Advance Planning for Care Act (MAP for Care Act), S. 3473, aims to encourage Medicare beneficiaries to voluntarily create and maintain advance directives—legal documents that outline a person's wishes for medical treatment if they become unable to make decisions themselves. The goal is to improve the quality and accessibility of end-of-life care planning through a federal certification program, while respecting state laws.
Key Provisions
- Establishment of the Program: The U.S. Secretary of Health and Human Services (through the Centers for Medicare & Medicaid Services, or CMS) must create the Medicare Advance Directive Certification Program within 5 years of enactment. This program promotes the adoption of "certified advance directives," which are electronically stored documents like living wills or powers of attorney for health care, recognized under state law.
- Definitions and Participation:
- A certified advance directive includes instructions on desired or undesired treatments and may name a health care proxy (a designated decision-maker).
- Eligible beneficiaries are those enrolled in Medicare Parts A, B, or C.
- Participation is fully voluntary; beneficiaries can enroll, register their directive, and disenroll or revoke it at any time.
- Enrollment and Access:
- Beneficiaries register directives with accredited vendors, providing details on how to access them.
- CMS notifies beneficiaries annually during the Medicare open enrollment period.
- Directives must be accessible in near real-time online to the beneficiary, authorized family or proxies, and healthcare providers, with options for hard copies.
- In disputes over treatment (e.g., when a beneficiary is incapacitated and family questions care decisions), certain relatives or potential decision-makers can access the directive.
- Accreditation of Vendors:
- CMS accredits entities (vendors) that offer certified directives, setting criteria for security, privacy, quality, and compliance with state laws.
- Vendors must allow use of state-specific statutory forms or alternative forms (verified by state attorneys), conduct annual quality reviews, and survey users on accessibility and effectiveness.
- Systems must meet HIPAA privacy standards (Health Insurance Portability and Accountability Act, which protects health information) and undergo security testing.
- Education and Outreach:
- CMS must include information on advance directives in Medicare notices, enrollment forms, and its website, with links to state-specific forms and resources.
- The website will feature both statutory (state-required) and alternative forms, plus a state-by-state index and disclaimers.
- Outreach promotes communication of wishes to family and providers, using modern tools like email or mobile apps.
- Privacy and Security:
- All systems comply with federal privacy laws, ensuring only authorized parties access directives.
- No federal preemption of state or local advance directive laws.
Significant Changes to Existing Law
- Adds a new section (Sec. 1849) to Part B of Title XVIII of the Social Security Act (Medicare), which previously had no dedicated federal program for certifying or promoting electronic advance directives.
- Introduces federal accreditation for vendors and standardized access/interoperability for directives, building on existing state-based systems without overriding them.
- Mandates CMS involvement in education and form dissemination, expanding beyond current voluntary Medicare counseling on advance care planning.
Potential Impacts
- On Government Agencies: CMS will face new administrative burdens, including program implementation, vendor accreditation, website maintenance, and annual notifications/surveys, potentially increasing costs but improving care coordination.
- On Citizens: Medicare beneficiaries (over 65 million enrollees) gain easier, secure tools to document end-of-life wishes, reducing family disputes and unwanted treatments; however, adoption remains voluntary, so uptake depends on awareness.
- On Healthcare Providers: Easier real-time access to directives could streamline decision-making in emergencies, potentially lowering costs from unnecessary care and aligning treatments with patient preferences.
- On International Relations: No direct impact, as the bill focuses on domestic Medicare policy.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary beneficiaries of easier planning and access to personalized care directives.
- Healthcare Providers and Suppliers: Gain quick access to directives, aiding compliance with patient wishes.
- Advance Directive Vendors and Entities: Must seek accreditation to participate, creating opportunities for technology providers in secure digital storage.
- CMS and Federal Government: Responsible for oversight, education, and enforcement.
- States and Families: States retain control over legal validity; families benefit from reduced conflicts in care decisions.
Notable Legal, Constitutional, or Political Implications
- Legal: Reinforces patient autonomy under existing federal laws like the Patient Self-Determination Act (1990), while deferring to state laws on directive validity—avoiding federalism conflicts. Includes judicial review for form approvals and dispute access processes, ensuring due process.
- Constitutional: No apparent challenges; aligns with privacy rights (via HIPAA) and does not compel participation, respecting individual liberty.
- Political: Promotes bipartisan advance care planning (introduced by Sens. Cassidy and Coons), potentially reducing healthcare spending on futile treatments (estimated at billions annually) without mandating changes, appealing to fiscal conservatives and patient advocates. May encourage broader adoption of digital health tools amid aging populations.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (2)
Sen. Coons, Christopher A. [D-DE], Sen. Van Hollen, Chris [D-MD]
Recent Actions
- 2025-12-15: Read twice and referred to the Committee on Finance.
- 2025-12-15: Introduced in Senate
Bill Versions
- Medicare Advance Planning for Care Act — issued 2025-12-15 — PDF (21 pages)