Utah Medicaid Provider Manual, Hospice Care Services § 8-9.5

For the duration of the election of hospice care, pediatric members may only

receive hospice care that is:

• Provided by the designated hospice agency, or

• Provided under arrangements made by the designated hospice agency.

Pediatric members who elect to receive hospice care services may also receive

concurrent Medicaid State Plan services for the terminal illness and other

related conditions.

Medicaid does not separately cover any modalities for palliative purposes as this

is the responsibility of the hospice agency.

• Services provided outside of the hospice benefit shall be reported directly

to Medicaid for coverage.

• Hospice agencies are not responsible for reimbursing other providers or

facilities for life-prolonging services rendered to pediatric members.

Hospice agencies performing pediatric care shall develop a training curriculum

to ensure that the hospice’s interdisciplinary team members, including

volunteers, are adequately trained to provide hospice care services. Staff

members and volunteers who provide pediatric hospice care services shall

receive training before providing hospice services and at least annually

thereafter. The training shall include the following pediatric-specific elements:

• Growth and development,

• Pediatric pain and symptom management,

• Loss, grief, and bereavement for pediatric families and the child,

• Communication with family, community, and interdisciplinary team,

• Psycho-social and spiritual care of children,

• Coordination of care with the child’s community,

• Medicaid adopts the National Hospice and Palliative Care Organization’s

(NHPCO) standards for pediatric hospice services.

A plan of care must be established by the interdisciplinary group. At least one of

the persons involved in development of the initial plan must be an appropriately

licensed practitioner acting within their scope of practice. The plan of care must

be consistent with the hospice philosophy of care. This plan must be established

on the same day as the face-to-face assessment and certification if the day of

assessment and certification is to be a covered day of hospice care.