Wis. ForwardHealth Online Handbook, Hospice, Topic #1141

Members receiving personal care who elect the hospice benefit may be eligible to continue receiving personal care services from

the personal care agency if those services are not directly related to the terminal illness.

If this criterion is met, the agency providing personal care services will have already received PA (prior authorization) for the

member. The personal care agency is required to submit a Prior Authorization Amendment Request (F-11042 (07/2012)) form

and attach a copy of the hospice POC (plan of care) that identifies the need for continued personal care services as well as the

specific services provided directly by the hospice. The POC must also indicate any aide services to be provided by the hospice.

This must be sent within seven calendar days of the member's election of hospice care.

When the personal care PA needs to be renewed, a current hospice POC must be included. Renewal of PA for personal care

services may be granted up to, but not exceeding, the current LOS (level of service). Additional personal care needs resulting

from the terminal illness are the responsibility of the hospice.