DE · guidance
Del. Medical Assistance Program Hospice Provider Specific Policy Manual § 7.2
Notification
7.2.1 Notification to DMAP must be followed by written confirmation using Medicaid
Form 1- Patient’s Hospice Activity Dates located in Section 10.0, Appendix A,
before submitting claims for payment.
7.2.2 Medicaid Form 1 must be submitted with the following documentation:
• Physician Certification of Terminal Illness (details located in section 1.2
titled Physicians Certification of Terminal Illness).
• Election Statement (details located in subsection 8.1 titled Election
Procedures)
• Physician’s Care Plan which must also be sent to the DMAP Fiscal Agent
Pharmacy Team. Contact information for the fiscal agent is located in the
Index, Section 20.0, of the General Policy Manual.
• Drugs listed on the Physician’s Care Plan that are related to the terminal
illness should be identified by an asterisk (*).
Provenance
- Source
- medicaidpublications.dhss.delaware.gov
- Retrieved
- 2026-10-01
- Edition
- dmap-hospice-2023-07-01
- Content hash
3217d35cac5acd84437a3de67880c2cf0d67358c6e6ac3477879fde273ef28f2
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.