Eli's Hospice Insider

Published on Fri Aug 16, 2013 PDF

You must explain that the beneficiary will forego curative care, MAC stresses.

Make sure you’re not glossing over the details of Medicare’s hospice benefit when you have patients sign their notice of election.

“Recent review by CGS has found that some hospice’s election statements do not include all of the requirements” Medicare mandates, the Medicare Administrative Contractor says in its June newsletter for home care providers. “The most common error identified was election statements that did not mention the patient’s understanding that hospice care was palliative rather than curative treatment.”

Warning: “The Benefit Policy Manual states that the election statement must include this information,” CGS stresses. “Any election statements that do not include this information are considered to not meet the requirements, and therefore, the claim will be denied.”

The NOE also must include identification of the hospice providing care; the patient’s/representative’s acknowledgement that the individual understands that certain Medicare services are waived by the election; the effective date of the election; and the signature of the patient/representative, CGS notes.

Take action: “Hospice agencies should review their election statement to ensure that they include all of the required information,” CGS directs. “Any election statement that does not contain all of the [required information] is considered invalid, and will result in a claim denial.”