Medicaid Hospice Policy Manual

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Section/Subsection	Title/Content	Policy Number	Issue/ Revised
100 General Information
Table of Contents	001	10/01/2019
	Definitions	003	10/01/2019
	Manual Instructions	101	10/01/2018
200 Program Description
	Legal Authority	202	10/01/2018
300 General Administration
	Member Rights	301	10/01/2018
	Fair Hearing Rights	302	10/01/2018
	Third Party Liability	304	10/01/2018
400 Eligibility for Services
	Eligibility Requirements	401	10/01/2018
	Election Periods	402	10/01/2018
	Certification of Terminal Illness	403	10/01/2019
	Election of Hospice Care	404	10/01/2018
	Election of Hospice Care Sample Form	404-1	10/01/2018
	RESERVED	405
	Discharge from Hospice Care	406	10/01/2018
	Revoking Hospice Care	407	10/01/2018
	Change of Designated Hospice	408	10/01/2018
	RESERVED	409
	Initial and Comprehensive Assessment of the Member	410	10/01/2019
	Interdisciplinary Group, Plan of Care and Coordination of Services	411	10/01/2018
	Quality Assessment and Performance Improvement	412	10/01/2018
	Infection Control	413	10/01/2018
	Licensed Professional Services	414	10/01/2018
500 Eligible Services
	Requirements for Coverage	500	10/01/2018
	Covered Services	501	10/01/2018
	Special Coverage Requirements	502	10/01/2018
	Admission to Hospice Care	503	10/01/2018
	Non-Covered Services	504	10/01/2018
	Special Requirements for Pre-Election Evaluation and Counseling	505	10/01/2018
600 Payment for Hospice
	Payment Procedures for Hospice	600	10/01/2018
	Payment Rates and Adjustments for Area Wage Differences	601	10/01/2018
	Hospice Cap Payment	602	10/01/2018
	Submission Requirements under the Quality Reporting Program	603	10/01/2018
	RESERVED	604
	Hospice Reimbursement for "Room and Board" Rate and Included Services	605	10/01/2018
700 Service Coordination
	Core Services	701	10/01/2018
	Furnishing Non-Core Services	702	10/01/2018
	Aide and Homemaker Services	703	10/01/2018
	Volunteers	704	10/01/2018
	Organization and Administration of Services	705	10/01/2018
	Hospice Medical Director	706	10/01/2018
	Clinical Records	707	10/01/2018
	Medical Supplies	708	10/01/2018
	RESERVED	709
	RESERVED	710
	Short Term Inpatient Care	711	10/01/2018
	Inpatient Hospice Facility Compliance Requirements	712	10/01/2018
	Hospice Care Provided by a SNF/NF or ICF/IID Facility	713	10/01/2018
	RESERVED	714
	Curative Care for Children Receiving Medicaid Hospice Services	715	10/01/2018