Magazine | January 24, 2011, Issue

Federal Health Care Act

Form 17Ai: End of Life/Authorized Life Termination/Difficult Next of Kin Reimbursement Procedures

Federal Guidelines for the Health Care Reform Act–authorized “End of Life Counseling” [ELC] procedures:

ELC sessions are now fully reimbursable as part of existing federal health-care programs and are encouraged for all patients of all ages and conditions.

Doctors will be reimbursed for conducting ELC sessions with ALL patients, and each facility is eligible to participate in the FAST-OUT-PREMIUM program, which reimburses at 175 percent each ELC that results in an Authorized Life Termination [ALT] within the same fiscal year.

Please note: You will be reimbursed ONLY if the following steps are completed and Forms XX7-1 and XX7-3 have been filed IN ADVANCE with your local billing center.

Prior to ELC session, please verify:

1. Patient is still breathing. (If patient is NOT breathing, or if this is a retroactive filing following a Non-Authorized Life Termination [NALT], please use form 17Bii: Post-Pull Authorization and Reimbursement Procedures.)

2. Patient registers life or lifelike symptoms in FOUR of the following six major areas: pulse, pupil dilation, light respiration, voice recognition, within earshot, in same general area (not to exceed 100 feet during counseling session).

3. Patient has not already filed Advanced Health Care Directive with sheaf of required paperwork from admission to hospital facility. PLEASE NOTE: Many facilities automatically enroll patients in the Federal Pull-the-Plug Plan (Reg. 12,965; page 4,520; Volume 47, Section 56R; ii) as a part of the sign-in process into a federal health-care facility. If this has ALREADY been accomplished, you WILL NOT be reimbursed for conducting the ELC. You MAY be eligible for PREMIUM FAST-TRAK reimbursement for Expedited Leave-Taking Procedures [ELTP] if you qualify. Please see NOTE A.

The ELC process as conducted must include the following points of discussion:

1. The intense pain the patient will undoubtedly suffer, right up until the end, unless “something else” is done.

2. The enormous cost and emotional toll on loved ones the patient is selfishly and pointlessly causing. [If loved ones refuse to participate or in some way remain obstructive, see NOTE B for additional reimbursement options.]

#page#3. Meeting all your old friends, family, nanas, and pets on the Rainbow Bridge, as has been confirmed by science.

4. Large catheter shown to patient — “Do you want this stuck up your you-know-what, or can I pull the plug?”

5. Explanation that “it’s just a cold” isn’t a diagnosis a non–medically trained person is qualified to make. A cough and a runny nose and an “achy feeling” is a terminal condition, in many cases.

6. The patient should be informed that a lifetime of “sore throats” and “allergies” brings up quality-of-life issues that need to be addressed. Loved ones tortured by the sound of sniffling and cough-syrup slurping — is that something the patient can live with?

7. If patient is sedated and/or medicated during ELC session, reimbursement will be given for medications ONLY upon death of patient.

8. Obese patients may be counseled while watching doctor scoop ice cream and/or hold a bacon double cheeseburger aloft.

9. If a nurse is present, she may, if advisable, appear topless.

10. Patient should be reminded of the future toll of environmental disaster, global warming, terrorism, economic unrest, and societal breakdown. Does patient really want to live through all of that?

NOTE A: For PREMIUM FAST-TRAK reimbursement for ELTP, please verify the following conditions:

1. Patient signed papers upon admission to facility;

2. Nurse and/or complementary health-care professional was out of the room;

3. Relatives/next of kin were distracted by television;

4. Machine was turned off in an undetected fashion;

5. Organs were harvested.

NOTE B: For Difficult Next of Kin [DNK]:

1. Difficult Next of Kin may be encouraged to participate in the ELC with a DNK Voucher. ONLY a DNK Voucher will be reimbursed and ONLY if signed and counter-signed by billing director in your area. NO EXCEPTIONS. DNK Vouchers come in denominations of $1,000, $5,000, and $10,000. Issuance of DNK Vouchers in excess of $25,000 REQUIRES two (2) signatures from billing department, and an accompanying form.

2. DNKs can be admitted into the hospital facility for any reason, and for any surgeries, if necessary to conduct an effective ELC. All surgeries and procedures will be reimbursed and no accompanying paperwork will be required.

Thank you for your adherence to these guidelines. If you have any questions, please refer to our FAQ at BEFORE you call our office.

Save our forests! Please file electronically!

In This Issue


Politics & Policy

Advantage: Obama

The overhyped political story of the moment is President Obama’s supposed comeback. That story notes that just weeks after his midterm “shellacking” he won congressional approval for a deal on ...
Politics & Policy

Budget War

The 2010 midterm election was a decisive victory for Republicans. From where they now sit — with a strong majority in the House and a much-improved position in the Senate ...
Politics & Policy

What the Whigs Knew

Eva Moskowitz is a traditional, down-the-line Democrat in almost every respect. She’s a Jewish New Yorker from a family of FDR liberals. “My grandmother would turn over in her grave ...


Politics & Policy

Socialism Is Back

‘Socialism” is a word that has vexed thoughtful conservatives since 2008, along with the related terms “Marxist,” “radical,” and the whole nomenclature of leftish extremism. In his painstakingly documented book ...

Books, Arts & Manners

Politics & Policy

Top Down

The ideology of the American ruling class has done great harm to those classes which do not have the privilege of ruling, and few people are better equipped to analyze ...
The Straggler

Shovel Ready

One of our township’s very few claims to fame, perhaps the only one, arises from its cesspools. The Wikipedia article headed “cesspool” devotes an entire paragraph to Huntington. In numbers ...


Politics & Policy


Defeats that Weren’t I would like to thank Mackubin Thomas Owens and James S. Robbins — the former for reviewing This Time We Win (“The Tet Myth,” December 20) and the ...
The Long View

Federal Health Care Act

Form 17Ai: End of Life/Authorized Life Termination/Difficult Next of Kin Reimbursement Procedures Federal Guidelines for the Health Care Reform Act–authorized “End of Life Counseling” [ELC] procedures: ELC sessions are now fully reimbursable ...
Politics & Policy


A C.S. LEWIS BODICE-RIPPER, FROM AFRICA In making books there is no end, And little merit. You have read Of world on world that has no friend, In volumes equally as dead; And if I ...

Mojo Myth

The president attended church in Hawaii, but he went the day after Christmas, so as not to distract from the other guy’s limelight. Decent of him; the babe only gets ...
Politics & Policy

Operation Rewind

While we like a good party now and again, the fact that House Republicans held no official gala to celebrate their accession to the majority in the new Congress reflects ...

Most Popular

Politics & Policy

Hillary Ruins the Plan

Editor’s note: Andrew C. McCarthy’s new book is Ball of Collusion: The Plot to Rig an Election and Destroy a Presidency. This is the first in a series of excerpts.  There really was a collusion plot. It really did target our election system. It absolutely sought to usurp our capacity for ... Read More

‘Good Verse, Bad Verse, and Chaos’

I love reading Sarah Ruden, and I’ve enjoyed the attention given to Walt Whitman in these pages over the last few days. Ruden gives the poet the back of her hand for being championed by — angels and ministers of grace, defend us! — intellectuals and professors, a poet “whom ordinary Americans most ... Read More
Economy & Business

The Great Mystery

Kevin Williamson disputes my characterization of his riposte. He writes: I wrote that people can choose what kind of work they want to do, and what kind of services they want to consume, without any help from Michael. Kevin then accuses me of being a stouthearted defender of the “Real America.” If ... Read More