42 CFR 489.12 – Federal Patient Self-Determination Act

(2) Are not required to implement an advance directive if, as a matter of conscience, the provider cannot implement an advance directive and State law allows any health care provider or any agent of such provider to conscientiously object.

(d) Prepaid or eligible organizations (as specified in sections 1883 (a)(1)(A) and 1876 (b) of the Act) must meet the requirements specified in 417.436 of this chapter. **

** The Regulations governing prepaid organizations (HMOs) mirror this part. Information is to be provided to individuals at the time of enrollment.

(e) If an adult individual is incapacitated- at the time of admission or at the start of care and is unable to receive information-(due to the incapacitating conditions or a mental disorder) or articulate whether or not he or she has executed an advance directive, then the provider may give advance directive information to the individual’s family or surrogate in the same manner that it issues other material about policies and procedures to the family of the incapacitated individual or to a surrogate or other concerned persons in accordance with State law. The provider is not relieved of its obligation to provide this information to the individual once he or she is no longer incapacitated or unable to receive such information. Follow up procedures must be in place to provide the information to the individual directly at the appropriate time.

Final Revisions: Vol. 60. No. 123, Tuesday. June 27, 1995, page 33294 forward

Interim Final Rule: Vol. 57 No. 45, Friday March 6, 1992, pages 8194-8204