Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.40 - SENIOR AND LONG TERM CARE SERVICES
Subchapter 37.40.8 - Hospice
Rule 37.40.806 - HOSPICE, COVERED SERVICES
Universal Citation: MT Admin Rules 37.40.806
Current through Register Vol. 18, September 20, 2024
(1) To be covered, hospice services must meet the following requirements:
(a) they must be reasonable and necessary for
the palliation or management of the terminal illness as well as related
conditions;
(b) the beneficiary
must elect hospice care in accordance with ARM
37.40.815;
(c) a plan of care must be established as set
forth in ARM
37.40.805
and
37.40.807
before services are provided. The services must be consistent with the plan of
care; and
(d) a certification that
the beneficiary is terminally ill must be completed as set forth in ARM
37.40.808.
(2) For covered hospice services, Medicaid will generally pay for the services covered by Medicare. Medicare coverage of hospice services is described under 42 CFR 418.200 through 418.205.
(a) Physician services is a covered hospice
service and must be performed by a doctor of medicine or osteopathy.
(b) Outpatient drugs and biologicals not
related to the terminal conditions will be reimbursed separately under the
provisions of ARM
37.86.1101,
37.86.1102,
and
37.86.1105.
AUTH: 53-6-113, MCA; IMP: 53-6-101, MCA
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