Medicare creates free advance directive registry to let seniors control end-of-life care

What it does

This bill creates a Medicare program requiring the federal government to establish a national registry where Medicare beneficiaries can voluntarily store and share advance directives (living wills, healthcare power-of-attorney documents) electronically. The Secretary of Health and Human Services will accredit private vendors to host these directives, set security and privacy standards, and display state-specific advance directive forms on a CMS website. Beneficiaries can enroll, update, or withdraw their directives at any time, and authorized family members, healthcare proxies, and providers can access them in emergencies.

Why we flagged it

The bill's core mechanism is establishing a voluntary, federally-supported registry for advance directives—a public health infrastructure project aimed at improving end-of-life care transparency and beneficiary control. It is not a subsidy, deregulation, or narrow carve-out; it is a straightforward expansion of Medicare beneficiary rights and information access.

What the text implies

• Vendors accredited under the program may collect aggregate data on beneficiary end-of-life preferences, creating a large dataset on mortality and treatment preferences that could be valuable for healthcare research, insurers, or pharmaceutical companies studying treatment patterns—though the bill does not explicitly authorize such secondary use.
• The requirement that vendors pass 'real-time tests simulating realistic volume' of simultaneous access may create a technical barrier to entry for smaller vendors, potentially concentrating the market among larger health IT firms with robust infrastructure.

The full analysis lists 4 implications of this text.

Who stands to gain

Health IT vendors providing advance directive storage and management services; Electronic health record (EHR) companies integrating with the registry; Advance directive accreditation organizations contracted by CMS