Ind. IHCP Hospice Services Provider Reference Module, Section 4

This section describes the Indiana Health Coverage Programs (IHCP) requirements for hospice election,

revocation and discharge. It also describes procedures related to changing hospice providers and short

absences for hospice patients.

The following topics are addressed:

• The IHCP forms that the hospice provider must complete and the procedures that hospice providers

must follow to submit these forms to the IHCP

• The coordination responsibilities that the hospice provider has for providing copies of these forms

to the nursing facility so that the facility staff can include copies of these forms in the IHCP hospice

member’s nursing facility medical chart

• Medical records standards that hospice providers are required to follow

Note regarding dually eligible hospice members residing in a nursing facility:

In states that have a Medicaid hospice benefit, the Omnibus Budget Reconciliation

Act of 1989 (OBRA-89) requires the state Medicaid agency to pay for room and

board under the Medicaid hospice program for dually eligible (Medicare and

Medicaid) hospice members residing in nursing facilities. Medicare pays for the

hospice services, and Medicaid pays for the member’s room and board as a pass-through payment to the hospice provider. The hospice provider then pays the nursing

facility according to their contract, which means dually eligible hospice members

must elect, revoke, be discharged from and change hospice providers using the

required forms of each program.

Hospice providers are reminded to pay close attention to this process, because the

IHCP has noted that hospice providers do not consistently ensure that dually

eligible hospice members residing in nursing facilities complete the Medicaid

hospice forms when they elect, revoke, are discharged from or change hospice

providers.

A Medicare beneficiary who elects hospice cannot remain in a Medicare-certified bed

in the nursing facility. The IHCP is paying for a room-and-board pass-through to the

hospice; therefore, the member must be in a Medicaid-certified bed.

(Medicaid hospice election, revocation, and discharge forms are not required for

dually eligible hospice members residing at home, because Medicare is reimbursing

for the hospice services and there are no nursing facility services for Medicaid to

reimburse.)