CMS SOM App. M, Tag L655

A hospice that has a written agreement with another agency, individual, or

organization to furnish any services under arrangement must retain administrative

and financial management, and oversight of staff and services for all arranged

services, to ensure the provision of quality care. Arranged services must be

supported by written agreements that require that all services be--

(1) Authorized by the hospice;

(2) Furnished in a safe and effective manner by qualified personnel; and

(3) Delivered in accordance with the patient's plan of care.

Interpretive Guidelines §418.100(e)

The hospice must retain administrative and financial management responsibility, and

oversight of staff and services provided under arrangement. For Medicare purposes, the

hospice is reimbursed for all covered services it provides, whether directly or under

arrangement. It is the responsibility of the hospice to pay for those services provided to

Medicare beneficiaries under arrangement. When a hospice provides services under

arrangements to non-Medicare beneficiaries, the hospice is responsible for establishing

how payment for those services will occur, but the standard does not require the hospice

to pay for those services directly or to pay for services for which there is no

reimbursement or for services that another insurer is obligated to pay.