Hospice Services. Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.
Hospice Services. The PH-MCO must provide hospice care and use certified hospice Providers in accordance with the provisions outlined at 42 C.F.R. 418.1 et seq. Recipients who are enrolled in the Department’s Hospice Program and were not previously enrolled in the HealthChoices Program will not be enrolled in HealthChoices. However, if a PH-MCO Member is determined eligible for the Department’s Hospice Program after being enrolled in the PH-MCO, the Member will remain the responsibility of the PH-MCO and will not be disenrolled from HealthChoices.
Hospice Services. Hospice care involves palliative care to terminally ill Members and their families with such services being centrally coordinated through a multi-disciplinary team directed by a Physician. Most hospice care is provided in the Member’s home or facility that the Member has designated as home. (i.e. Assisted Living Facility, Nursing Home, etc.) All eligible hospice services must be billed by the hospice provider. Benefits for hospice care include the following services provided to a Member by a hospice provider responsible for the Member's overall care: Professional services provided by a registered nurse or licensed practical nurse; Palliative care by a Physician; Medical and surgical supplies and durable medical equipment; Prescribed drugs related to the hospice diagnosis (drugs and biologicals); Oxygen and its administration; Therapies (physical medicine, occupational therapy, speech therapy); Medical social service consultations; Dietitian services; Home health aide services; Family counseling services; Continuous Home Care provided only during a period of crisis in which a patient requires continuous care which is primarily nursing care to achieve palliation or management of acute medical symptoms; and Inpatient services of an acute medical nature arranged through the hospice provider in a hospital or skilled setting to address short-term pain and/or symptom control that cannot be managed in other settings. The member is not eligible to receive further hospice care benefits if the member or the member's authorized representative elects to institute curative treatment or extraordinary measures to sustain life. Benefits for Covered Hospice Services are provided until the earlier date of your death or discharge from Hospice Care.
Hospice Services. Services necessary for the palliation and management of terminal illness and related conditions. These services include supportive care provided to the family and other individuals caring for the terminally ill recipient. Wis. Admin Code DHS 107.31(2) Hospitalization: An inpatient stay at a certified hospital as defined in Wis. Admin Code DHS 101.03(76).
Hospice Services. Hospice services are covered under the Hoosier Care Connect Program. Hoosier Care Connect members receiving hospice services will remain enrolled with their MCE even while receiving inpatient (non-hospice) care. Examples of inpatient non-hospice care includes but are not limited to: rehabilitation facilities, skilled nursing facilities and hospital admissions. For further information on Hospice services consult the Indiana Medicaid Medical Policy Manual, the Hospice Module and the Prior Authorization Module, Managed Care Programs Policies and Procedures Manual.
Hospice Services. The CHC-MCO must provide Hospice and use certified Hospice Providers in accordance with 42 C.F.R. Subpart G. The CHC-MCO must coordinate with Hospice Providers for Dual Eligible Participants who are receiving Hospice through their Medicare coverage. Hospice provided to Participants by Medicare-approved Hospice Providers is directly reimbursed by Medicare.
Hospice Services. In accordance with 1905(o)(3)(C), 1902(a)(13)(B) and 1902(a)(32) of the Act, and 42 CFR 447.10, the MCP shall pay room and board payments to the hospice provider instead of the nursing facility if the member resides in a nursing facility and is receiving hospice services. Room and board payments to the hospice provider must be at least 95% of the nursing facility rate.
Hospice Services. M. Fifty percent (50%) of the average wholesale price (AWP) related to chemotherapy drugs (intravenously administered) and injectable medications administered during a visit to the physician’s office (excluding take-home insulin).
Hospice Services. Hospice services include services provided by a Medicare certified hospice agency or, when a Medicare certified hospice agency is not available, services that are equivalent to those provided in a Medicare certified hospice agency. For purposes of this section, “equivalent” means that the Enrollee:
Hospice Services. Hospice care may be provided in the home or at a Hospice facility where medical, social and psychological services are given to help treat patients with a terminal illness. Hospice Services include routine home care, continuous home care, Inpatient Hospice and Inpatient respite. To be eligible for Hospice benefits, the patient must have a life expectancy of six months or less, as certified by the attending Physician and hospice medical director. Covered Health Services will continue if the Enrollee lives longer than six months, provided the hospice medical director or other hospice doctor recertifies that You are terminally ill. Covered Hospice Services include the following list. Skilled Nursing Services by an R.N. or L.P.N. Diagnostic Health Services to determine need for palliative care. Physical, speech and inhalation therapies if part of a treatment plan. Medical supplies, equipment and appliances directed at palliative care. Counseling services. Inpatient confinement at a Hospice. Prescription Drugs given by the Hospice. Home health aide functioning within home health care guidelines. Non-Covered Hospice Services include services provided by volunteers and housekeeping services.
