AZ · guidance
AHCCCS Medical Policy Manual, Policy 310-J, § III
Policy
Hospice care is a comprehensive set of services identified and coordinated by an interdisciplinary
group to provide palliative and support care for terminally ill members and their family members
and/or caregivers for the physical, psychosocial, spiritual, and emotional needs as specified in a
specific patient plan of care.
Hospice care is covered for all terminally ill members who meet the specified medical criteria and
requirements under A.R.S. §§ 36-2907, 36-2939, 36-2989, and 42 CFR Part 418 et seq.
In order to receive hospice care, members shall waive the right to duplicative services including:
hospice care provided by a non-designated hospice service, services that are related to the
treatment of the terminal condition or a related condition, unless provided by the designated
hospice, provided by the attending physician, or provided as room and board by a nursing facility
where the member is a resident as specified in CMS Medicaid Manual section 4305.2. This waiver
does not apply to EPSDT-aged members.
If the hospice agency is unable or unwilling to provide or cover medically necessary services related
to the hospice diagnosis, the services shall be provided by the Contractor. The Contractor, however,
shall report such cases to Arizona Department of Health Services (ADHS) as the hospice licensing
agency in Arizona.
History
AMPM Policy 310-J effective dates: 10/01/07, 01/25/19, 10/01/22; approval dates: 10/01/09, 10/01/10, 07/20/11, 10/01/13, 11/15/18, 04/14/22.
Provenance
- Source
- www.azahcccs.gov
- Retrieved
- 2026-10-01
- Edition
- ampm-310-j-2022-10-01
- Content hash
01f20574609d65431de3507460d05dd28fc9a86dded690e052f7e097da2d0745
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