S.C. Medicaid Hospice Services Provider Manual § 3

PROVIDER QUALIFICATIONS

In addition to conditions of participation in the Medicaid program outlined in the Provider

Administrative and Billing Manual, the following also apply to hospices in order to participate in the

Medicaid program:

• The hospice must be currently licensed under the provisions of South Carolina state law.

• The hospice must meet Title XVIII standards for Medicare participation and be certified as

eligible for participation in the Medicare program.

• The hospice must develop written policies and procedures on advance directives in compliance

with Section 1902(a) (57) of the Social Security Act.

• The hospice must attend provider orientation conducted by the SCDHHS. Provider orientation

will be held at a minimum one time a year. To attend a session, a written request to become a

Medicaid hospice provider must be mailed to:

Department of Health and Human Services

Division of Community and Facility Services

Post Office Box 8206

Columbia South Carolina 29202-8206.

The Provider Enrollment Form and SCDHHS Provider Contract will be supplied upon completion of

the session.

In addition to completing a Provider Enrollment Form and a SCDHHS Provider Contract, a hospice

must also submit all of the following information to the hospice program manager:

• A copy of the letter from the South Carolina Department of Public Health (SCDPH), Division of

Health Licensing, showing the license number and the effective date of the license or a copy of

the current license.

• A copy of the letter from the SCDPH, Division of Survey and Certification, showing that the

hospice has been recommended for certification or meets the requirements for the Medicare

program.

• A copy of the written notification to the hospice from the Medicare fiscal intermediary showing

the approved reimbursement rate, the fiscal year-end and Medicare provider ID number.

In compliance with Section 1902(a)(57) of the Social Security Act, a hospice must do all of the

following:

• Provide written information to patients regarding their rights under state law to make decisions

concerning their medical care, including the right to accept or refuse medical or surgical

treatment and the right to formulate advance directives.

• Provide written information to individuals regarding the institutions or program’s written policies

respecting the implementation of the right to formulate advance directives.

• Document in the patient’s medical record whether or not an advance directive has been

executed.

• Comply with all requirements of state law respecting advance directives.

• Provide (individually or with others) education for staff and the community on issues concerning

advance directives.

• Not condition the provision of care or otherwise discriminate against an individual who has

executed an advance directive.