New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-W - Former Division of Human Services
Chapter He-W 500 - MEDICAL ASSISTANCE
Part He-W 544 - HOSPICE SERVICES
Section He-W 544.07 - Change in Designated Hospice Provider

Universal Citation: NH Admin Rules He-W 544.07

Current through Register No. 40, October 3, 2024

(a) A recipient or his or her agent or legal guardian may change the designated hospice provider once in each of the election periods specified in He-W 544.05(a) .

(b) The recipient or his or her agent or legal guardian shall complete the hospice care provider's change of designated provider form and provide it to the current hospice provider and the newly designated hospice provider.

(c) The recipient's current hospice provider shall notify the department within 5 state business days of a recipient changing his or her designated hospice provider via the applicable sections of Form 282A, "Medicaid Hospice Care Notification Form," incorporated by reference in He-W 544.17

(d) The recipient's current hospice provider shall forward the following to the newly designated hospice provider:

(1) A copy of the election statement obtained by the current hospice provider in accordance with He-W 544.04; and

(2) A copy of the certification of terminal illness obtained by the current hospice provider in accordance with He-W 544.06.

(e) The newly designated hospice provider shall comply with all requirements of He-W 544, except that the forms forwarded pursuant to (d) above may be used in place of completing new documents.

#9726-A, eff 7-1-10

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