Ind. IHCP Hospice Services Provider Reference Module, Section 4, Nursing Facility Hospice Discharge

For hospice members residing in a nursing facility, hospice providers are required to provide a copy of the

Medicaid Hospice Discharge form to the appropriate staff in the nursing facility to ensure that the form is

included in the hospice member’s nursing facility clinical record and that the facility staff is aware of the exact

date that the hospice provider discharged the member from hospice care. To ensure better communication

about reimbursement issues between the hospice and nursing facility, the hospice must develop coordination

procedures with appropriate staff in the nursing facility billing department so that the nursing facility biller is

aware that the member was discharged from hospice care and can resume billing the IHCP directly for nursing

facility care the date after the hospice discharge.

The hospice provider must bill the IHCP for the hospice per diem and for nursing facility room and board

for the date of the hospice discharge. The reason for this reimbursement guideline is that the individual is

still under hospice care on that day. The nursing facility can resume billing the IHCP directly for nursing

facility care for the date of service after the hospice discharge date, once the hospice provider has supplied

them with a copy of the Medicaid Hospice Discharge form that was processed by the PA-UM contractor.

Hospice providers must not bill the IHCP for room and board for the date of death of a nursing facility

resident. Current IHCP regulations for nursing facility reimbursement state that the IHCP does not pay the

nursing facility for the date that a resident is physically discharged from the facility. For reimbursement

purposes, a nursing facility resident’s date of death is equivalent to nonpayment for the date of the

resident’s physical discharge from the nursing facility. The election of hospice care by a nursing facility

resident does not rescind the current reimbursement regulations for nursing facility room-and-board

services.