skilled nursing facilities, and emergency medical 
services within a State; and 
(2) expanding an existing program for physi-
cian orders regarding life-sustaining treatment to 
serve more patients or enhance the quality of serv-
ices, including educational services for patients and 
patients’ families, training of health care profes-
sionals, or establishing a physician orders for life- 
sustaining treatment registry. 
(c) DISTRIBUTION OF FUNDS.—In funding grants 
under this section, the Secretary shall ensure that, of the 
funds appropriated to carry out this section for each fiscal 
year— 
(1) at least one-half are used for establishing 
new programs for physician orders regarding life- 
sustaining treatment; and 
(2) remaining funds are to be used for expand-
ing or enhancing existing programs for physician or-
ders regarding life-sustaining treatment. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible entity’’ includes— 
(A) an academic medical center, a medical 
school, a State health department, a State med-
ical association, a multistate task force, a hos-
pital, or a health system capable of admin-
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istering a program for physician orders regard-
ing life-sustaining treatment for a State; or 
(B) any other health care agency or entity 
as the Secretary determines appropriate. 
(2) The term ‘‘physician order for life-sus-
taining treatment’’ has the meaning given such term 
in section 1861(iii)(4) of the Social Security Act, as 
added by section 2. 
(3) The term ‘‘program for physician orders for 
life-sustaining treatment’’ means a program that— 
(A) supports the active use of physician or-
ders for life-sustaining treatment in the State; 
and 
(B) is guided by a coalition of stakeholders 
that includes patient advocacy groups and rep-
resentatives from across the continuum of 
health care services, such as disability rights 
advocates, senior advocates, emergency medical 
services, long-term care, medical associations, 
hospitals, home health, hospice, the State agen-
cy responsible for senior and disability services, 
and the State department of health. 
(4) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
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(e) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for each of the fiscal years 
2012 through 2017. 
SEC. 4. ADVANCE CARE PLANNING STANDARDS FOR ELEC-
TRONIC HEALTH RECORDS. 
Notwithstanding section 3004(b)(3) of the Public 
Health Service Act (42 U.S.C. 300jj–14(b)(3)), not later 
than January 1, 2013, the Secretary of Health and 
Human Services shall adopt, by rule, standards for a 
qualified electronic health record (as defined in section 
3000(13) of such Act (42 U.S.C. 300jj(13)), with respect 
to patient communications with a health care provider 
about values and goals of care, to adequately display the 
following: 
(1) The patient’s current advance directive (as 
defined in section 1866(f)(3) of the Social Security 
Act (42 U.S.C. 1395cc(f)(3)), as applicable. 
(2) The patient’s current physician order for 
life-sustaining treatment (as defined in section 
1861(iii)(4) of the Social Security Act (42 U.S.C. 
1395x(iii)(4)), as applicable. 
A standard adopted under this section shall be treated as 
a standard adopted under section 3004 of the Public 
Health Service Act (42 U.S.C. 300jj–14) for purposes of 
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certifying qualified electronic health records pursuant to 
section 3001(c)(5) of such Act (42 U.S.C. 300jj– 
11(c)(5)). 
SEC. 5. PORTABILITY OF ADVANCE DIRECTIVES. 
(a) IN GENERAL.—Section 1866(f) of the Social Se-
curity Act (42 U.S.C. 1395cc(f)) is amended by adding 
at the end the following new paragraph: 
‘‘(5)(A) An advance directive validly executed outside 
the State in which such directive is presented must be 
given effect by a provider of services or organization to 
the same extent as an advance directive validly executed 
under the law of the State in which it is presented. 
‘‘(B) In the absence of knowledge to the contrary, 
a physician or other health care provider or organization 
may presume that a written advance health care directive 
or similar instrument, regardless of where executed, is 
valid. 
‘‘(C) In the absence of a validly executed advance di-
rective, any authentic expression of a person’s wishes with 
respect to health care shall be honored. 
‘‘(D) The provisions of this paragraph shall preempt 
any State law on advance directive portability to the extent 
such law is inconsistent with such provisions. Nothing in 
the paragraph shall be construed to authorize the adminis-
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tration of health care treatment otherwise prohibited by 
the laws of the State in which the directive is presented.’’. 
(b) MEDICAID.—Section 1902(w) of the Social Secu-
rity Act (42 U.S.C. 1396a(w)) is amended by adding at 
the end the following new paragraph: 
‘‘(6)(A) An advance directive validly executed outside 
the State in which such directive is presented must be 
given effect by a provider or organization to the same ex-
tent as an advance directive validly executed under the law 
of the State in which it is presented. 
‘‘(B) In the absence of knowledge to the contrary, 
a physician, other health care provider, or organization 
may presume that a written advance health care directive 
or similar instrument, regardless of where executed, is 
valid. 
‘‘(C) In the absence of a validly executed advance di-
rective, any authentic expression of a person’s wishes with 
respect to health care shall be honored. 
‘‘(D) The provisions of this paragraph shall preempt 
any State law on advance directive portability to the extent 
such law is inconsistent with such provisions. Nothing in 
the paragraph shall be construed to authorize the adminis-
tration of health care treatment otherwise prohibited by 
the laws of the State in which the directive is presented.’’. 
Æ 
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