The controversy over "death panels" in the health care system may not be buried yet.

Starting Jan. 1, 2011, the government will pay physicians to counsel patients on end-of-life-care options, a new policy embedded in Medicare regulation by the Obama administration.

Advocates of the policy in Congress have been keeping quiet about its fruition because of worries it may bring up the 2009 controversy over the wildly criticized "death panels," reports The New York Times.

The new rule states that Medicare will pay for "voluntary advance care planning," encouraging doctors to discuss end-of-life treatment options with patients during their annual visits.

Physicians can offer information on preparing an "advanced directive," which notes patients' wishes about the degree of care they would like to receive if they are too ill to make health care decisions.

The new policy was achieved through the regulation-writing process, which is likely to become a more frequently used tool by the administration as Republican power grows in Congress, according to the NYT.

In the preamble to the Medicare regulation, the Obama administration quoted research that points to the benefits of end-of-life planning.

The study, published in the British Medical Journal in March, found that advanced care planning can potentially improve end-of-life care for patients and at the same time reduce stress for the family.

Researchers at the University Hospital in Melbourne, Australia, enrolled 309 inpatients who were at least 80 years old in the study. Some were randomly assigned usual care and others usual care with facilitated advanced care planning. Researchers followed up with the patients for six months or until death.

Out of the 154 patients who were assigned advanced care planning, 81 percent received it and expressed end-of-life wishes. Family members of the patients who died reported experiencing significantly lower levels of stress and anxiety when compared to the control group.

"Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety, and depression in surviving relatives," the study authors wrote. "We specifically focused on a model with five key elements identified by others as crucial to successful advance care planning: trained facilitators, patient-centered discussions, involvement of family in discussions, correctly filed documentation, and systematic education of doctors."

Critics of the regulation say the policy could be used to deprive or prematurely withdraw critically ill or disabled people from life-sustaining treatment.

The White House fired back on Sunday, saying the new Medicare directive does not revive the controversial "death panels" language but rather draws upon guidelines for end-of-life consultations set in place under George W. Bush. A law passed and signed by Bush in 2008 specified that medical visits for seniors can include conversations about "end-of-life planning," reports The Wall Street Journal.

"The only thing new here is a regulation allowing the discussions ... to happen in the context of the new annual wellness visit created by the Affordable Care Act," Reid Cherlin, a White House spokesman, told the WSJ.

In a September poll by the Kaiser Family Foundation, 30 percent of Americans 65 and older said the new health care law enables a government panel to control end-of-life care decisions for Medicare beneficiaries - a false claim, according to the NYT.

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