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 37.40.815 - HOSPICE, ELECTION AND WAIVER OF OTHER BENEFITS

Universal Citation: MT Admin Rules 37.40.815

Current through Register Vol. 18, September 20, 2024

(1) A beneficiary eligible for hospice care or their representative must file an election statement with a particular hospice in order to receive such care. The department will follow Medicare regulations and guidelines in administering this provision, including 42 CFR 418.20 through 418.30.

(2) A beneficiary waives all rights to Medicaid payments for the duration of the election of hospice care for the following services:

(a) Hospice care provided by a hospice other than the hospice designated by the beneficiary (unless provided under arrangements made by the designated hospice).

(b) Any Medicaid services that are related to the treatment of the terminal condition for which hospice care was elected or a related condition or that are equivalent to hospice care except for:
(i) services provided by the designated hospice;

(ii) services provided by another hospice under arrangements made by the designated hospice; and

(iii) services provided by the beneficiary's attending physician if that physician is not an employee of the designated hospice or receiving compensation from the hospice for those services.

(3) The hospice chosen by the eligible beneficiary, or their representative, must file the original Notice of Election (NOE) or a copy, with the department within five calendar days of the start of Medicaid Hospice Services. NOEs must be sent to the Senior & Long Term Care Division, 1100 N. Last Chance Gulch, P.O. Box 4210, Helena, MT 59604-4210. The department may waive the consequences of failure to submit a timely filed NOE. A hospice must fully document and furnish any requested documentation to the department for a determination of exception.

(4) When the hospice election is ended due to discharge, the hospice must file a Notice of Termination of Election with the department within five calendar days after the effective date of the discharge, unless it has already filed a final claim for that beneficiary. Notice of Terminations must be sent to the Senior & Long Term Care Division, Sanders 1100 N. Last Chance Gulch, P.O. Box 4210, Helena MT 59604-4210.

AUTH: 53-6-113, MCA; IMP: 53-6-101, MCA

Disclaimer: These regulations may not be the most recent version. Montana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.