Mich. Medicaid Provider Manual, Hospice § 3.1

A terminally ill Medicaid beneficiary who lives in a hospice service area and whose life expectancy is six

months or less (if the illness runs its normal course), as determined by a licensed physician and the

Hospice Medical Director, has the option for admission into a hospice program. A representative, such as

a spouse, parent, legal guardian, or other authorized adult, may act on behalf of the beneficiary.

Medicaid does not cover Hospice services if the following conditions exist:

• The individual is not eligible for the Medicaid benefit.

• The beneficiary does not meet the hospice’s admission criteria.

• If the beneficiary is currently enrolled in a Medicaid Health Plan (MHP), the hospice services must

be arranged and reimbursed by the MHP.

All Hospice admission activities must be conducted according to MDHHS policies and in such a manner as

to maximize the beneficiary’s ability to make a choice between admission into hospice or maintaining

current active treatment with Medicaid coverage. Such activities must assure that the beneficiary fully

understands how to use hospice services and that all care must be received from or through the hospice

(except those services not related to the terminal illness or services provided by their attending

physician).

It is imperative that the Hospice provider review the Conditions of Admission with the beneficiary and

answer any questions raised by the beneficiary and/or authorized representative.