Mont. Medicaid Hospice Policy Manual, Policy 706

MEDICAL

DIRECTOR

The hospice must designate a physician to serve as medical

director. The medical director must be a doctor of medicine or

osteopathy who is an employee, or is under contract with the

hospice. When the medical director is not available, a physician

designated by the hospice assumes the same responsibilities and

obligations as the medical director.

MEDICAL DIRECTOR

CONTRACT

A hospice may contract with either of the following:

1. A self-employed physician; or

2. A physician employed by a professional entity or

physicians group. When contracting for medical

director services, the contract must specify the

physician who assumes the medical director

responsibilities and obligations.

INITIAL CERTIFICATION OF

TERMINAL ILLNESS

The medical director or physician designee reviews the clinical

information for each hospice member and provides written

certification that it is anticipated that the member’s life expectancy

is six months or less if the illness runs its normal course. The

physician must consider the following when making this

determination:

1. The primary terminal condition;

2. Related diagnosis(es), if any;

3. Current subjective and objective medical findings;

4. Current medication and treatment orders; and

5. Information about the medical management of any of

the patient's conditions unrelated to the terminal

illness.

RECERTIFICATION OF THE

TERMINAL ILLNESS

Before the recertification period for each patient, as described in

HH Policy 403, the medical director or physician designee must

review the patient's clinical information.

MEDICAL DIRECTOR

RESPONSIBILITY

The medical director or physician designee has responsibility for

the medical component of the hospice's patient care program.