Mich. Medicaid Provider Manual, Hospice § 2

Hospice providers are bound to all rules, regulations, and policies specified in this chapter for program

participation/enrollment of Medicaid beneficiaries. Hospice providers must also comply with the Medicare

Conditions of Participation (42 CFR § 418) which generally apply to non-Medicare beneficiaries as well as

to Medicare beneficiaries.

Additional information regarding federal Hospice requirements and guidelines is contained in the Center s

for Medicare & Medicaid Services (CMS) State Operations Manual 2083.

Michigan Department of Health and Human Services (MDHHS) requires Hospice agencies to be licensed

in Michigan by the state-licensing agency, certified by Medicare, and enrolled in Medicaid. (Refer to the

General Information for Providers Chapter of this manual for additional information.)

Hospice providers cannot engage in any of the following marketing-related practices:

• Provide cash, gift incentives, or rebates to prospective covered persons;

• Claim superior medical care or provider skills; or

• Make untruthful statements regarding the merits of the hospice.

The use of marketing practices that mislead, confuse, or defraud either the beneficiary or MDHHS is

considered grounds for terminating the hospice from participation in Medicaid. Such actions may also

result in investigation leading to possible prosecution under applicable State and Federal statutes.

The exceptions are 42 CFR § 418.60 and 42 CFR § 418.98(c) conditions that apply

only to Medicare beneficiaries.