Ga. Medicaid Part II Policies & Procedures for Hospice Services § 701

To qualify for the hospice program, all individuals must:

701.1. Be Medicaid eligible.

701.2. Be certified as terminally ill with a medical prognosis of life expectancy of six (6)

months or less if the disease runs its normal course. The certification of terminal illness

of an individual who elects hospice shall be based on the attending physician’s or

medical directors, if designated to be the attending physician, clinical judgment

regarding the normal course of the individual’s illness while understanding that making

medical prognostication of life expectance is not always exact. See Section 704

regarding the member’s hospice certification.

701.3. Sign and date a Medicaid Hospice Election Form.

701.4. The hospice agency is responsible for verifying Medicaid eligibility. Verify Medicaid

eligibility by reviewing the individual’s Medicaid card monthly, using the Gainwell

Technologies Voice Response System, or the Gainwell Technologies web portal. If the

individual is not currently Medicaid eligible, or determined to have SSI, the

individual or representative must apply for Hospice Medicaid coverage at their local

Division of Family and Children Services (DFCS). A Hospice Care Communicator

(Form 527A) must be completed and faxed to the local DFCS office (See Appendix C

for instructions).