MO HealthNet Hospice Provider Manual § 2.6

An individual or representative may revoke the election of hospice care at any time by filing a Notification of Termination of Hospice Benefits with the hospice that includes a signed statement that the individual revokes the election for MO HealthNet coverage of hospice care for the remainder of that election period. The effective date of the revocation is the date of the patient or patient representative signature, unless a subsequent date is designated. An individual or representative may not designate an effective date earlier than the date that the revocation is signed. The individual forfeits hospice coverage for any remaining days in that election period.

A revocation of hospice services is always the participant's choice. A hospice may not revoke an election because the participant is admitted to a hospital or chooses other curative care. Medicare and MO HealthNet do not recognize ‘revocation by action.’ It is the responsibility of the hospice to determine that the patient and patient’s family fully understand that by electing hospice, the patient waives the right to treatment of the terminal illness except that treatment provided or arranged by the hospice or provided by the attending physician. The patient must understand that they can be financially liable for curative treatment not arranged by the hospice or provided by the attending physician. If the patient chooses to disregard this and is admitted to the hospital, the hospice cannot automatically remove the participant from hospice care.

Upon revoking the election of MO HealthNet coverage of hospice care for a particular election period, an individual resumes MO HealthNet coverage of the benefits waived when hospice care was elected. Individuals may at any time elect to receive hospice coverage for any other hospice election periods for which they are eligible.

The hospice must advise MHD as soon as possible and no later than five (5) days from the date of the patient’s signature on the Notification of Termination of Hospice Benefits. The hospice must fax a copy of the form to MHD.

Refer to Section 3 in this manual for more information on this form.