Mont. Medicaid Hospice Policy Manual, Policy 407

REVOKING THE

ELECTION OF

HOSPICE CARE

A member or representative may revoke the member's election of hospice

care at any time during an election period.

To revoke the election of hospice care, the member or representative

must file a statement with the hospice that includes the following

information:

1. A signed statement that the member or representative

revokes the member's election for Medicaid coverage of

hospice care for the remainder of that election period; and

2. The date that the revocation is to be effective. (A member or

representative may not designate an effective date earlier

than the date that the revocation is made).

A member, upon revocation of the election of Medicaid coverage of

hospice care for a particular election period:

1. Is no longer covered under Medicaid for hospice care;

2. Resumes Medicaid coverage of the benefits waived under

37.40.815, (Refer to Hospice Policy 404); and

3. May at any time elect to receive hospice coverage for any

other hospice election periods that he or she is eligible to

receive.

When the hospice election is ended due to revocation, the hospice must

file a notice of termination/revocation of election with the Department

within five calendar days after the effective date of the revocation, unless it

has already filed a final claim for that beneficiary.