Medi-Cal Provider Manual, Part 2, Hospice Care, Emergency Services

‹‹In the event Medi-Cal members who have elected to receive hospice services seek

assistance at an emergency room or request emergency transportation, the emergency

service provider should obtain the name of Medi-Cal members’ hospice provider and notify

them immediately. Hospice providers must take appropriate action and document the

emergency services in Medi-Cal members’ medical records.››

Requirements

‹‹Providers are reminded that Health and Safety Code, Section 1317, states that emergency

services and care shall be provided to any person (Medi-Cal member) requesting such

services or care, or for whom such services or care are requested, for any condition in which

the person (Medi-Cal member) is in danger of loss of life, or serious injury or illness, at any

licensed health facility that maintains and operates an emergency department. In addition,

emergency services and care shall be rendered without first questioning Medi-Cal members

regarding their ability to pay.

Note: Hospice services do not meet the definition of or otherwise qualify as emergency

services under Medi-Cal policy and consistent with federal definitions.››

Palliative Care Services

Medi-Cal providers may bill for medically necessary palliative care services for eligible

Medi-Cal members diagnosed with a serious and/or life-threatening illness, as determined

and documented by Medi-Cal members’ treating health care providers.

More information can be found in the Palliative Care section of the appropriate Part 2

Medi-Cal provider manual.