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 544.10 - Documentation of Hospice Services

Universal Citation: NH Admin Rules He-W 544.10

Current through Register No. 40, October 3, 2024

(a) Hospice providers shall maintain documentation in their records to fully support each claim billed for services.

(b) Hospice providers' records shall include forms created by the providers which address the following:

(1) Recipient election of hospice care in accordance with He-W 544.04;

(2) Provider certification of terminal illness in accordance with He-W 544.06;

(3) Change in designated hospice provider in accordance with He-W 544.07; and

(4) Revocation of hospice care in accordance with He-W 544.08.

(c) Hospice provider records shall also include copies of any forms submitted to the department.

(d) Hospice providers shall maintain any other supporting records in accordance with He-W 520.

(e) Hospice providers shall submit to the department a copy of the provider's annual Medicare Cost Report, by November 30 of each year.

(f) Within 30 days following the end of each quarter, for each recipient who died within that quarter, hospice providers shall notify the department of hospice service utilization via Form 282B, "Service Utilization within Hospice by Recipient," incorporated by reference in He-W 544.17, except that this form shall not be required for dual-eligible hospice recipients who reside in a nursing facility.

#9726-A, eff 7-1-10

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