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 544.08 - Revocation of Hospice Care

(a) The recipient or his or her agent or legal guardian may revoke the recipient's election of hospice care at any time by completing and signing the hospice care provider's hospice care revocation form.

(b) If the revocation form in (a) above cannot be signed at the time of revocation, the following shall occur:

(c) A recipient or his or her agent or legal guardian shall not designate a revocation effective date earlier than the date the revocation is made as allowed in (a) and (b) (1) above.

(d) Within 5 state business days of a recipient revoking his or her election of hospice care, the designated hospice shall notify the department of the date that the revocation is to be effective, via the applicable sections of Form 282A, "Medicaid Hospice Care Notification Form," incorporated by reference in He-W 544.17.

(e) Effective with the revocation date specified, the recipient shall no longer be covered under the hospice benefit and shall resume eligibility for all Title XIX benefits previously waived pursuant to He-W 544.02(a) (4) .

(f) A recipient who revokes his or her election of hospice care shall be eligible to elect hospice care for any remaining election periods in accordance with He-W 544.04.