Sponsors (2)
The bill makes it substantially easier for Medicare beneficiaries to create, access, and have their advance-care preferences honored by establishing electronic advance directives with privacy safeguards and outreach, but it introduces administrative costs, market compliance burdens, and heightened data-security and state-consistency risks.
Medicare beneficiaries can create, store, and share legally recognized electronic advance directives and receive near-real-time electronic access plus required hard-copy availability, increasing the likelihood that their care preferences are available and followed during emergencies and routine clinical encounters.
Medicare beneficiaries retain clear control over their directives because they may disenroll and terminate directives at any time, preserving individual autonomy over end-of-life care decisions.
Medicare beneficiaries benefit from standardized privacy, security, and HIPAA-aligned protections that reduce the risk of unauthorized access to sensitive advance care instructions.
Medicare beneficiaries face increased privacy and security risk because centralized registries and data sharing create higher-value targets for cyberattacks, and breaches could expose sensitive end-of-life preferences.
Taxpayers, hospitals, and vendors may face higher costs because implementing and maintaining the program (CMS administration, accreditation, testing, and surveys) creates administrative and compliance burdens that could be passed to providers or reduce market competition.
Medicare beneficiaries may experience inconsistent user experiences and legal uncertainty across states because State-preserved variation in advance directive laws remains despite federal posting and standards.
Based on analysis of 2 sections of legislative text.
Directs CMS to create a certified electronic system for Medicare advance directives with enrollment, accreditation, privacy, access, outreach, and state-form posting within five years.
Creates a Medicare program that builds a national electronic advance directive certification system run by HHS/CMS. The system must support voluntary beneficiary enrollment and disenrollment, certify and accredit advance directive tools, post state and alternative forms, protect privacy consistent with HIPAA, provide near-real-time electronic access plus hard copies, run outreach during enrollment periods, and include dispute and quality-review processes — all to be implemented within five years, with a 60-day timeline for posting alternative state forms after notice.
Introduced December 15, 2025 by Gregory Francis Murphy · Last progress December 15, 2025