Posted on Monday, November 16, 2020

The Centers for Medicare & Medicaid Services (CMS) updated the Medicare Benefit Policy Manual, Chapter 9 to reflect changes to the hospice election statement and the new election statement addendum.  CMS Transmittal 10437/Change Request (CR) 12015 revises the Manual to include the following:

In the fiscal year (FY) 2020 Hospice final rule (84 FR 38484), CMS finalized modifications to the hospice election statement content requirements at § 418.24(b) to increase coverage transparency for patients under a hospice election. Chapter 9 of the Manual, Section 20.2.1.1 Hospice Election Statement now includes the following to reflect these changes:

  • The individual’s acknowledgement that the individual has been provided information on the hospice’s coverage responsibility and that certain Medicare services are waived by the election. For hospice elections beginning on or after October 1, 2020, this would include providing the individual with information indicating that services unrelated to the terminal illness and related conditions are exceptional and unusual and the hospice should be providing virtually all care needed by the individual who has elected hospice;

For hospice elections beginning on or after October 1, 2020 the hospice must provide:

  • Information on individual cost-sharing for hospice services;
  • Notification of the individual’s (or representative’s) right to receive an election statement addendum if there are conditions, items, services, and drugs the hospice has determined to be unrelated to the individual’s terminal illness and related conditions and would not be covered by the hospice;
  • Information on the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), including the right to immediate advocacy and BFCC-QIO contact information

Source: NAHC

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