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October 1, 2020

New Hospice Election Requirements

The fiscal year 2021 Hospice Final Rule (CMS-1733-FExternal PDF) included new hospice election statement and the hospice election statement addendum requirements. The new requirements for the election statement and addendum are effective for all hospice elections beginning on or after October 1, 2020.

As a result, CGS has updated the Hospice Election Requirements webpage to include the following new requirements that must be included in the hospice election statement.

  • Information about the holistic, comprehensive nature of the Medicare hospice benefit;
  • A statement that, although it would be rare, there could be some necessary items or services that will not be covered by the hospice because the hospice has determined that these items or services are to treat a condition that is unrelated to the terminal illness and related conditions.
  • The statement would also include information about possible beneficiary cost-sharing for hospice services.
  • Notification of the beneficiary's (or representative's) right to request an election statement addendum that includes a written list and a rationale for the conditions, items, drugs, or services that the hospice has determined to be unrelated to the terminal illness and related conditions and that expedited advocacy is available through the Beneficiary Family Centered Care-Quality Improvement Organization (BFCC-QIO) review if the beneficiary (or representative) disagrees with the hospice's determination.

As a reminder, hospices may develop their own Hospice election statements and certifications of terminal illness. Please review the following model examples for specific requirements that must be included for valid documentation.

Please share this information with your appropriate staff.

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