Vt. Medicaid Hospice Provider Manual § 7

The member is certified as being terminally ill in accordance with § 418.22. A member is

considered to be terminally ill if the medical prognosis is that the member’s life expectancy is 6

months or less if the illness runs its normal course. Only a medical doctor, doctor of osteopathy, or

naturopathic doctor (Medicaid-only for naturopathic doctor) can certify or re-certify a member as

terminally ill. In the event that a member’s attending physician is a nurse practitioner, or a

physician assistant, the hospice medical director or the nurse practitioner of the hospice

Interdisciplinary Group can certify the member as terminally ill.

Face-to-Face Encounter - For recertifications, a hospice physician or hospice nurse practitioner

must have a face-to-face encounter (must be co-signed by physician) with each hospice member

whose total stay across all hospices is anticipated to reach the 3rd benefit period. The face-to-face

encounter must occur prior to, but no more than 30 calendar days prior to, the 3rd benefit period

recertification, and every benefit period recertification thereafter, to gather clinical findings to

determine continued eligibility for hospice care.