Mont. Medicaid Hospice Policy Manual, Policy 500

REQUIREMENTS

FOR COVERAGE

To be covered, hospice services must meet the following

requirements:

1. The services must be reasonable and necessary for

the palliation and management of the terminal illness

as well as related conditions;

2. The member must elect hospice care in accordance

with 37.40.815 (refer to Hospice Policy 404);

3. A plan of care must be established and periodically

reviewed by the attending physician, the medical

director, and the interdisciplinary group of the hospice

program (refer to Hospice Policy 411);

4. The plan of care must be established before hospice

care is provided;

5. The services provided must be consistent with the

plan of care; and

6. A certification that the member is terminally ill must be

completed.