La. Medicaid Services Manual ch. 24 (Hospice) § 24.1

To be eligible to elect hospice, a beneficiary must meet all Louisiana Medicaid eligibility criteria

and be certified as terminally ill. “Terminally ill” is defined as a medical prognosis of limited

expected survival, of approximately six months or less at the time of referral to a hospice, of an

individual who is experiencing an illness for which therapeutic strategies directed toward cure and

control of the disease alone are no longer appropriate.

Both the Bureau of Health Services Financing ( BHSF) - Certification of Terminal Illness (CTI)

Form and the BHSF - Notice of Election (NOE) Form must be completed, and a plan of care (POC)

must be established. Prior authorization (PA) requirements stated in Section 24.6 – Prior

Authorization of this chapter are applicable to all election periods. (See Appendix A for the NOE

form and Appendix B for the CTI form).

Medicare and Medicaid (Dual Eligibles)

If the beneficiary is eligible for Medicare as well as Medicaid, the hospice care must be either

elected or revoked simultaneously under both programs. Medicare is the primary payer.