Ind. IHCP Hospice Services Provider Reference Module, Section 5, Clarification about Hospice Authorization and Hospice Billing for a Hospice Member Discharged From the Hospital

This section provides policy clarification for those hospice agencies whose corporation also has a distinct

home health agency.

When an IHCP home health member is discharged from the hospital to return home, the IHCP provides the

home health agency with a 30-day grace period from the date of the hospital discharge to submit a request

for IHCP PA to the FFS PA-UM contractor. However, this policy does not apply to the IHCP hospice

member. The hospice provider is required to submit the IHCP hospice authorization request within 10 days

of the date of hospice election or the start date of a hospice benefit period, regardless of whether the

member elects hospice in the hospital or was admitted to the hospital during a hospice benefit period.

Hospice providers must ensure that the provision of hospice services is consistent with all Medicare hospice

conditions of participation, including the requirement that the hospice have a contract with the hospital

stipulating that the hospice is the manager of the individual’s hospice care, as described in 42 CFR 418.100(e).

For more information regarding this subject, see the policy directive found in the Hospice Providers’

Contractual Responsibilities as the Professional Manager of a Member’s Hospice Care section.