Hospice Sample Clauses

Hospice g. Individuals whose permanent residence and principal work location are outside the State of Minnesota and outside of the service areas of the health plans participating in Advantage. If these individuals use the plan administrator’s national preferred provider organization in their area, services will be covered at Benefit Level Two. If a national preferred provider is not available in their area, services will be covered at Benefit Level Two through any other provider available in their area. If the national preferred provider organization is available but not used, benefits will be paid at the POS level described in paragraph “i” below. All terms and conditions outlined in the Summary of Benefits will apply.
Hospice. Hospice care is not covered under the Hoosier Healthwise program; however, terminally ill members may qualify for hospice care under the fee-for-service Medicaid program once they are disenrolled from Hoosier Healthwise. The hospice provider can submit a hospice election form for the member to the IHCP Prior Authorization Unit. The IHCP Prior Authorization Unit will then initiate the disenrollment of the member from managed care and facilitate hospice coverage. The Contractor must coordinate care for its members that are transitioning into hospice by providing to an IHCP hospice provider any information required to complete the hospice election form for the Contractor’s terminally ill members desiring hospice, as described in the IHCP Hospice Provider Manual.
Hospice. Shall be defined as a coordinated plan of home and/or Inpatient Services, which treats a Terminally III patient and his or her family as a unit, focusing on providing comfort rather than on curing an illness. The plan provides Services to meet the special needs of the family unit during the final stages of a Terminal Illness and during bereavement. These services may include physical care, counseling, drugs, equipment and supplies for the terminal illness and related condition(s). Services are provided by a team made up of trained medical personnel, homemakers and counselors. The team acts under an independent hospice administration and helps the family unit cope with physical, psychological, spiritual, social and economic stress. Hospice is generally provided in the home, is not limited to people with cancer, and must be approved as meeting established standards, including but not limited to compliance with any licensing requirements of Guam, and the benefit period begins on the date the attending physician certifies that a covered member is terminally ill.
Hospice. The term "Hospice" means a facility that is licensed, accredited or approved by the proper authority to provide a Hospice Care Program and which admits individuals who have no reasonable prospect of a cure and have a life expectancy of six months or less.
Hospice. Hospice care when provided by a licensed hospice care program. A hospice care program is a coordinated program of home and inpatient care, available 24 hours a day. This program uses an interdisciplinary team of personnel to provide comfort and supportive services to a Member and any family members who are caring for the member, who is experiencing a life-threatening disease with a limited prognosis. These services include acute, respite and home care to meet the physical, psychosocial and special needs of the Member and their family during the final stages of illness. In order to qualify for hospice care, the Member’s provider must certify that the Member is terminally ill and is eligible for hospice services. Inpatient Hospice Services. For short-term care, inpatient hospice services are covered with Preauthorization. Respite care is covered to provide continuous care of the Member and allow temporary relief to family members from the duties of caring for the Member for a maximum of 5 consecutive days per 3-month period of hospice care. Other covered hospice services, when billed by a licensed hospice program, may include the following: • Inpatient and outpatient services and supplies for injury and illness. • Semi-private room and board, except when a private room is determined to be necessary. • Durable medical equipment when billed by a licensed hospice care program. Hospice care requires Preauthorization. No charge; Member pays nothing Exclusions: Private duty nursing; financial or legal counseling services; meal services; any services provided by family members Hospital - Inpatient and Outpatient The following inpatient medical and surgical services are covered: • Room and board, including private room when prescribed, and general nursing services. • Hospital services (including use of operating room, anesthesia, oxygen, x-ray, laboratory and radiotherapy services). • Drugs and medications administered during confinement. • Medical implants. Hospital - Inpatient: After Deductible, Member pays 20% Plan Coinsurance Hospital - Outpatient: After Deductible, Member pays $30 Copayment and 20% Plan Coinsurance Exclusions: Private duty nursing; housekeeping or meal services; any care provided by or for a family member; any other services rendered in the home which do not meet the definition of skilled home health care above • Acute chemical withdrawal (detoxification). Outpatient hospital includes ambulatory surgical centers. Alternative care arrangements m...
Hospice. Residents 21 and over on hospice will be reimbursed at 50% of the Medicaid rate otherwise payable to the facility for services provided. Payments cannot exceed 14 days in any 12 month period. Administration should be aware that the Veteran’s Administration may pay for a designated number of bed hold days in accordance with the provisions of the contract. If a bed hold paid for by the Veteran’s Administration expires, the bed may be reserved by the resident and/or resident’s representative for the prevailing private rate. The facility is not obligated to hold a bed for which there is no bed hold payment arrangement. Shaker Place Rehabilitation and Nursing Center shall notify the resident and/or resident’s representative of the first available bed that becomes available.
Hospice. The City’s health indemnity plan will be amended to define a Hospice Facility as a public or private organization licensed and operated according to the law, primarily engaged in providing palliative support, and other related care for a covered person diagnosed as terminally ill with a medical prognosis that life expectancy is six months or less. The Hospice must have an interdisciplinary medical team consisting of at least one physician, one registered nurse, one social worker, one volunteer and a volunteer program. A Hospice is not a facility or part thereof which is primarily a place for rest, custodial care of the aged, drug addicts, or alcohols, or a hotel or similar institution.
Hospice. Maintain a current state hospice license and Medicare certification from CMS and provide services in compliance with Medicare Conditions of Participation and state regulations. Hospice will notify the facility immediately concerning any proposed, threatened or actual revocation or termination of state license or Medicare certification.