Apple Health (Medicaid) Provider Alert
Update to Hospice Services Billing Guide – Effective
May 1, 2018
The Health Care Authority
(HCA) revised the Hospice Services Billing Guide, effective May 1,
2018, to clarify what providers must do to receive Medicaid payment for
services provided to hospice clients.
Important clarifications
regarding requirements for submitting a copy of the completed HCA/Medicaid
Hospice Notification form (HCA 13-746) include:
-
HCA must receive the HCA/Medicaid
Hospice Notification form within five business days from when a client
begins the first day of hospice care, or has a change in hospice status. This
includes payment for clients who are eligible for Medicare in a nursing home,
or will be admitting to one, who have not yet applied or been approved for
Medicaid at the time of hospice election
-
If you are unable to
verify the Medicaid eligibility of a client, or that they have submitted their
application, you must still submit the HCA/Medicaid Hospice Notification
form within five business days of a client electing hospice services.
- Medicare does not pay for
the cost of room and board services provided by a nursing facility to hospice
clients. Medicaid does pay for the cost of room and board services for those clients
who meet program requirements, including the timely receipt of the HCA/Medicaid
Hospice Notification form.
For a full list of the
changes in the billing guide, see the “What has changed” table. The updated
billing guide is located on HCA’s Provider billing guides and fee schedules web page.
|
