Mich. Medicaid Provider Manual, Hospice § 6.7.D

If the beneficiary is enrolled in the waiver program, the hospice must contact the

beneficiary's waiver coordinator/agent. A joint POC must be retained in the beneficiary’s

record by both the hospice and the waiver coordinator. The hospice is the primary

provider and manages the joint POC. The POC must clearly identify the services the

beneficiary receives, which entity is responsible for providing the services, and the

frequency of the services to be provided. Each waiver service included in the POC should

be accompanied by documentation stating why the service is not covered under hospice.

The waiver coordinator must understand the hospice philosophy so that the two agencies

work for a common goal and eliminate duplicate services. Ongoing communication and

coordination must occur regularly between the two providers during the time they are

serving the same beneficiary. Written documentation of this ongoing communication and

coordination must be kept in the beneficiary’s record at each agency.

Beneficiaries may receive services from both types of providers concurrently as long as

the services are not duplicative.

If the beneficiary is receiving hospice and becomes eligible to receive waiver services, the

waiver agency contacts the hospice to establish the first date of service for the waiver

services. It is the responsibility of the waiver agent to complete the beneficiary’s MI

Choice waiver enrollment in CHAMPS. However, if the beneficiary is receiving waiver

services and becomes eligible for hospice, it is the responsibility of the hospice to

complete the hospice admission in CHAMPS. The appropriate Program Enrollment Type

(PET) identifies a beneficiary receiving hospice services and Adult Home and Community

Based Waiver for the Elderly and Disabled (MI Choice Waiver) services concurrently (e.g.,

MIC-HSSP). The waiver agency and the hospice provider must discuss and coordinate

services in order to prevent delays in access of care.

Hospice services must be used to the fullest extent before additional waiver services of

the same type are provided. Post-payment review may be employed to monitor services.

If inappropriate (e.g., duplicative) waiver services were provided, MDHHS will seek

recovery of Medicaid funds paid for those services from the waiver coordinator.

MDHHS maintains a list of MI Choice waiver coordinators and contact information on the

MDHHS website. (Refer to the Directory Appendix for website information.) Habilitation

Supports waiver coordinators may be contacted through the local Prepaid Inpatient

Health Plan (PIHP)/Community Mental Health Services Program (CMHSP) provider.