Mich. Medicaid Provider Manual, Hospice § 5.4

The physician or permitted non-physician practitioner (NPP) must have a face-to-face encounter with

every hospice beneficiary prior to the 180th day of recertification of the beneficiary’s terminal illness for

the purpose of determining continued eligibility. The 180th day recertification is defined as the

recertification that occurs at the start of the third benefit (election) period or the benefit period following

the second 90-day benefit period. Additionally, a face-to-face must be conducted at each subsequent

recertification (every 60 days thereafter) for as long as the beneficiary is in hospice. Face-to-face

encounters must occur no more than 30 calendar days prior to the start of the third benefit period and no

more than 30 calendar days prior to each subsequent benefit period thereafter.

Permitted NPPs include:

• A nurse practitioner or clinical nurse specialist (as defined in section 1861(aa)(5) of the Social

Security Act) who is working in collaboration with the physician in accordance with State law.

• A physician assistant (as defined in section 1861(aa)(5) of the Social Security Act) under the

supervision of the physician.

The physician or NPP must attest in writing to the face-to-face encounter with the beneficiary and include

the date of the visit. An NPP is allowed to perform and attest to the face-to-face encounter; however,

the initial certification for hospice must be completed by a physician.

Failure to meet the face-to-face encounter requirements results in a failure by the hospice to meet the

recertification of the terminal illness requirement. This results in the beneficiary no longer being eligible

for the hospice benefit. If this should occur, the hospice must complete the admission in CHAMPS, with

the last date of the benefit period as the effective discharge date. A comment in the Remarks Section on

the Discharge webpage is required to explain the reason for the discharge.

It is the responsibility of the first hospice to complete the discharge in CHAMPS before the second

hospice can complete the admission in CHAMPS when:

• the beneficiary discharges from one provider for admission to a new provider;

• the beneficiary revokes the services of a provider; or

• the provider discharges the beneficiary.

The new hospice provider may begin their care within the beneficiary’s first benefit period.

In the event a hospice provider is resuming care for a beneficiary formerly served by their hospice, the

resuming hospice provider must have previously completed the discharge in CHAMPS at the time hospice

services originally ended. To resume care, the hospice must complete a new admission in CHAMPS. The

resumption of care starts in the next or subsequent benefit period.