CMS Pub. 100-02, ch. 9, § 40.1.3.1

The attending physician is a doctor of medicine or osteopathy, a nurse practitioner, or a

physician assistant and is identified by the individual, at the time he or she elects to

receive hospice care, as having the most significant role in the determination and delivery

of the individual’s medical care.

The election statement must include the patient’s choice of attending physician. The

information identifying the attending physician should be recorded on the election

statement in enough detail so that it is clear which physician, NP, or PA was designated

as the attending physician. This information should include, but is not limited to, the

attending physician’s full name, office address, NPI number, or any other detailed

information to clearly identify the attending physician. Hospices have the flexibility to

include this information on their election statement in whatever format works best for

them, provided the content requirements in 42 CFR 418.24(b) are met. The language on

the election form should include an acknowledgement by the patient (or representative)

that the designated attending physician was the patient’s (or representative’s) choice.

If a patient (or representative) wants to change his or her designated attending physician,

he or she must follow a procedure similar to that which currently exists for changing the

designated hospice. Specifically, the patient (or representative) must file a signed

statement with the hospice that identifies the new attending physician in enough detail so

that it is clear which physician, NP, or PA was designated as the new attending physician.

This information should include, but is not limited to, the attending physician’s full name,

office address, NPI number, or any other detailed information to clearly identify the

attending physician. The statement must include the date the change is to be effective,

the date that the statement is signed, and the patient’s (or representative’s) signature,

along with an acknowledgement that this change in the attending physician is the

patient’s (or representative’s) choice. The effective date of the change in attending

physician cannot be earlier than the date the statement is signed.