Hospice Discharge, Revocation and Transfers
The Medicare hospice benefit is only available to beneficiaries who are terminally ill. A hospice may discharge a beneficiary in certain situations. A beneficiary or representative may choose to revoke the election of hospice care at any time. In addition, a beneficiary may transfer hospice agencies only once in each benefit period. Select the topic below for additional information.
The election of the hospice benefit is the beneficiary’s choice rather than the hospice’s choice, and thus, the hospice cannot revoke the beneficiary’s election. Therefore, when a hospice agency admits a beneficiary to hospice, it may not automatically or routinely discharge the beneficiary at its discretion, even if the care promises to be costly or inconvenient.
Medicare regulations at 42 CFR 418.26 define three reasons for discharge from hospice care:
When a patient is discharged from hospice care, the beneficiary:
Hospices may bill for the day of discharge.
A hospice revocation is a beneficiary’s choice to no longer receive Medicare covered hospice benefits. To revoke the election of hospice care, the beneficiary/representative must give a signed written statement of revocation to the hospice. No standardized hospice revocation form exists.
Upon revoking the election of Medicare coverage of hospice care for a particular election period, an individual resumes Medicare coverage of the benefits waiver when hospice care was elected. In cases where the individual was enrolled in a Medicare Advantage (MA) Plan at the time they elected hospice, all Medicare claims will continue to be paid by the fee-for-service contractor (A/B MAC) until the first day of the month following the revocation.
An individual may, at any time, re-elect to receive hospice coverage, provided that the beneficiary is otherwise entitled to hospice care benefits.
A revocation is the beneficiary’s choice rather than the hospice’s choice, and the hospice cannot revoke the beneficiary’s election. In addition, the hospice cannot request nor demand the beneficiary revoke his/her election.
An individual may change the designation of the hospice they receive care from only once in each election period.
A change of ownership is not considered a change in the beneficiary’s designation of a hospice agency, and requires no action by the beneficiary.
Last Updated: 07.20.12
|Two Vantage Way, Nashville, TN 37228||©2016 CGS Administrators, LLC. All Rights Reserved|