The CMS will pay physicians to help Medicare patients plan the type of care they want at the end of life, an idea that touched off the “death panel” controversy six years ago, but which has since gained broader acceptance.

The CMS rule, proposed last summer and finalized Friday, takes effect Jan. 1. The physician counseling is voluntary, and could be provided during seniors’ annual wellness visits, or other regular office visits. “We believe patients and families deserve the opportunity to discuss these issues with their physician and care team,” said Dr. Patrick Conway, the CMS’ chief medical officer .

The CMS decided not to limit how often such counseling could take place, Conway said, in part because of feedback from doctors and the public stating that people may need repeat counseling as their health needs change. “If you made a choice and you become more ill, you might want to have the discussion again,” Conway said.

U.S. Rep. Earl Blumenauer (D-Ore.), who pushed for the policy, said advance directives must be made easily accessible, and that doctors should receive training on how to have these difficult conversations.