{"ref":"DC-HSP-ELC-02","title":"Certification and Recertification of Terminal Illness and Face-to-Face Encounters","category":"Hospice care","summary":"Sets how the Agency obtains a timely, complete written certification of terminal illness for every benefit period, who may certify, what the certification and narrative must say, how face-to-face encounters are made before the third and later periods (in person while the District is under the hospice enrollment moratorium), and the extra DC Medicaid signature and timing rules.","inShort":["Every benefit period needs a written physician certification that the patient is terminally ill.","A certification can be signed no more than 15 calendar days before the period starts.","The physician writes a narrative about this patient, immediately above the signature, with no check boxes.","Before the third period and every later one, a hospice physician or nurse practitioner sees the patient within the 30 days before recertification.","While the District is under the hospice enrollment moratorium, face-to-face encounters are made in person."],"primaryCitation":"42 CFR §418.22","citations":["29 DCMR §939.7","29 DCMR §939.8","29 DCMR §939.9","29 DCMR §939.31","29 DCMR §940.4","29 DCMR §940.5"],"federalCitations":["42 CFR §418.22","42 CFR §418.102(b)-(c)","42 CFR §418.25","42 CFR §418.3","42 CFR §424.507(b)"],"surveyorAsks":["Show me the certification for each benefit period of this patient. Were they signed within the time allowed?","Who signed the initial certification? Was the attending physician’s certification obtained?"],"forms":[{"ref":"DC-HSP-ELC-02-A","title":"Certification or Recertification of Terminal Illness"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.22(a)(1))","5. When the Certification Is Obtained","6. Who Certifies","7. What the Physician Considers","8. What the Certification Says","9. Oral Certification","10. Face-to-Face Encounters","10.1 Telehealth Encounters and the Moratorium","11. Tracking Recertifications","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"dc-hospice","state":"Washington, DC","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}