Ill. HFS Handbook for Hospice Agencies, Topic K-211.1

The physician certification must identify the diagnosis of a terminal illness that

prompted the patient to elect hospice care. It must include a statement that the

individual’s medical prognosis is that the patient’s life expectancy is six (6) months or

less if the terminal illness runs its normal course.

If the hospice cannot obtain the written certification within 2 calendar days, after a

period begins, it must obtain an oral certification within 2 calendar days and the

written certification before it submits a claim for payment.

The certification must also include the date and signature(s) of the physician(s).

Recertification may be completed no more than 30 calendar days prior to the start of

the subsequent benefit period.

For the initial ninety (90) -day periods, (see Topic K-211.4, Benefit Periods), the

hospice must obtain written certification statements from the medical director of the

hospice or the physician member of the hospice interdisciplinary group and the

participant’s attending physician. For subsequent periods, the only requirement is

certification by the medical director of the hospice or the physician member of the

hospice interdisciplinary group. A copy of the physician certification must be

maintained in the hospice patient record and is subject to post-payment audit.