Va. DMAS Hospice Provider Manual ch. IV, Introduction

Under the Medicaid program, hospice care must not be of any less or greater duration,

scope, or quality than that provided to individuals not receiving state and/or federal

assistance.

Hospice is a coordinated program of home and inpatient care as defined in 12 VAC5-391

(Virginia Department of Health). The hospice provider employs an interdisciplinary team

to assist in providing palliative care to meet the special needs of enrolled individuals. The

hospice model of care utilizes volunteers and family members, training them to provide

much of an individual’s care. This unique combination of professional staff, volunteers,

and family members ensures a greater magnitude of services can be provided to an

individual within his or her home, allowing for the highest quality of life and avoiding

unnecessary institutionalization.

To be covered, hospice services must be reasonable and necessary for the palliation or

management of the terminal illness, if the terminal illness runs its normal course. The

individual must be certified as being terminally ill and must elect hospice coverage. A

plan of care must be established and services must be consistent with the plan of care.