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October 2, 2026

Implementation of the Mandatory Hospice Election Statement Addendum

Prior to October 1, 2026, the hospice election statement addendum was only required to  be furnished to beneficiaries (or their representatives) upon request. However, CMS  published a final rule in August 2026 that finalized the policy to make the hospice election statement addendum mandatory for all hospice elections beginning on and after  October 1, 2026 (91 FR 49118External PDF). The hospice election statement must be furnished, in writing (which can be paper or electronic) to the beneficiary or their representative.

The required content of the hospice election statement addendum is described in § 418.24(c)External Website.

Medicare Administrative Contractors have been authorized to use enforcement discretion  during a limited 3-month window (for hospice elections that started on or after October  1, 2026 through December 31, 2026) to ensure industry is aware of and compliant with the above requirement. Upon review, MACs would not deny claims for impacted hospices  solely for lacking a compliant addendum or an incomplete addendum. At the cessation of  the grace period, all conditions of payment would continue to be followed.

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