Mich. Medicaid Provider Manual, Hospice § 5.2

A hospice must obtain written certification of the terminal illness for each election period before a claim

for services is submitted. If the hospice is unable to obtain a written certification within three days of

initiation of hospice care, a verbal certification must be obtained, documented, and signed by the person

receiving the certification. Statements covering a beneficiary’s initial certification must be obtained from

the hospice medical director or the physician member of the Interdisciplinary Group (IDG), and the

beneficiary’s attending physician if the beneficiary has an attending physician. The hospice medical

director or the physician member of the IDG certifies the terminal illness for all subsequent election

periods.

Each written certification must include:

• A statement that the beneficiary’s life expectancy is six months or less if the terminal illness runs

its normal course;

• Specific clinical findings and other documentation as needed to support the life expectancy of six

months or less;

• A brief narrative summary;

• An explanation why the clinical findings of the face-to-face encounter support a life expectancy of

six months or less (beginning with the third benefit period and thereafter); and

• Physician signature(s), date signed, and specific election period dates covered by the certification

or recertification.

Documentation of all written/verbal certifications must be prepared no more than 15 calendar days prior

to the effective date of election and must be kept in the beneficiary’s medical record.