N.H. Medicaid Hospice Provider Manual, Vol. II, § 2, Certification of Terminal Illness

The hospice provider shall obtain certification of terminal illness as follows:

1. For the first 90-day election period, the hospice provider shall obtain, within 2 calendar days

after hospice care is initiated, written certification of terminal illness signed and dated by:

a. The medical director of the hospice provider or the physician member of the hospice

interdisciplinary group; and

b. The member’s NH Medicaid enrolled, attending physician, if the member has an

attending physician. An APRN shall not be allowed to sign;

2. For subsequent election periods of coverage, the hospice provider shall obtain, within 2

calendar days after the beginning of each election period, a written certification of terminal

illness that has been signed and dated by the medical director of the hospice provider, or the

physician member of the hospice interdisciplinary group;

3. If the written certification in (1) or (2) above cannot be obtained within 2 days, a verbal

certification shall be:

a. Obtained within 2 days;

b. Documented in the member’s medical records; and

c. Followed by a written certification pursuant to (1) or (2) above within 30 calendar

days; and

4. No NH Medicaid payment shall be made for days prior to the certification(s) specified in (1)–

(3) above.