Hospice agency reporting requirements

Washington State Health Care Authority sent this bulletin at 09/08/2021 01:57 PM PDT

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Hospice agency reporting requirements

The Health Care Authority (HCA) sends you this notification as a reminder of hospice agency notification requirements.

Requirement

Hospice agencies are required to notify HCA within five working days from when an Apple Health (Medicaid) client begins the first day of hospice care or has a change in hospice status to include discharges, revokes, provider changes, and change in place of service.

Why this is important

When a hospice agency fails to notify HCA’s hospice program manager within five working days of these changes, the client can suffer disruptions when attempting to fill prescriptions. The client or family is then forced to go without, or pay for the prescription.

HCA has seen an increase in Hospice providers not submitting hospice notification form 13-746 for client discharges within five working days of the date the client was discharged. To be reimbursed for providing hospice services, the hospice agency must complete the form and forward it to HCA's hospice program manager within five working days from when an HCA client begins the first day of hospice care, or has a change in hospice status to include discharges, revokes, provider changes and change in place of service.

Failure to notify HCA properly of a client’s discharge or revocation from hospice care could result in the client not receiving medically necessary services.

Additional resources

Hospice billing guide
WAC 182-551-1340 - When a client leaves hospice without notice
WAC 182-551-1350 - Discharges from hospice care

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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