New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 53A - HOSPICE SERVICES MANUAL
Subchapter 2 - PROVIDER REQUIREMENTS
Section 10:53A-2.2 - Changing from one hospice to another

1. An individual may change hospices once in each benefit period. The change of the hospice is not considered a revocation of the election of hospice services.

2. In order to change the designation of the hospice, an individual shall file a signed statement, the Change of Hospice, FD-384 form incorporated herein by reference as Form #7 in the Appendix, with the hospice where the individual was initially enrolled and also with the newly designated hospice. The statement shall include the following information:

3. The original hospice of enrollment and the new hospice must send the Hospice Eligibility Form, FD-383 to the medical assistance customer center (MACC), county welfare agency (CWA), or , as applicable, Division of Child Protection and Permanency (DCP&P) in order to change providers. (See Form #6, the Hospice Eligibility Form, FD-383, in the Appendix in this chapter, incorporated herein by reference and 10:53A-3.2 for the policy for medical and financial eligibility for Medicaid/NJ FamilyCare FFS).