{"ref":"FL-HSP-ELC-02","title":"Certification and Recertification of Terminal Illness and Face-to-Face Encounters","category":"Hospice care","summary":"Sets how the Agency obtains written certification and recertification of terminal illness for each benefit period (42 CFR §418.22): who may certify, when, and what the certification must contain, including the physician’s own narrative; face-to-face encounters before the third benefit period and every later one; when telehealth may and may not be used for those encounters through December 31, 2027; and the Florida duty of the medical director to validate the prognosis.","inShort":["Every benefit period needs a signed physician certification before billing: 90 days, 90 days, then every 60 days.","First period: the hospice physician and the attending physician (if any, and a doctor) both certify.","The physician writes the narrative personally and signs right below the attestation. Never pre-write it.","From the third period, a hospice physician or nurse practitioner must see the patient within 30 days before recertification.","Do face-to-face visits in person while a hospice moratorium covers Florida, unless the Administrator approves telehealth in writing."],"primaryCitation":"42 CFR §418.22","citations":["s. 400.6095(2), F.S.","s. 400.601(10), F.S.","Rule 59A-38.008(2)(b)1.-2., F.A.C.","s. 400.611(2), F.S."],"federalCitations":["42 CFR §418.22","42 CFR §418.21","42 CFR §418.25","42 CFR §418.102(b)-(c)","42 CFR §418.3","42 CFR §418.104(a)(5)"],"surveyorAsks":["Show me the certification for this patient’s first benefit period. Who signed, and on what dates?","Where is the physician’s narrative, and the attestation directly above the signature?"],"forms":[{"ref":"FL-HSP-ELC-02-A","title":"Certification of Terminal Illness and Face-to-Face Attestation"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.22; Rule 59A-38.008(2)(b)2., F.A.C.)","5. Who Certifies","6. Timing","7. Content of the Certification","8. Face-to-Face Encounters","8.1 Telehealth face-to-face encounters","9. Patients Who Are Not Medicare Beneficiaries","10. When a Patient Cannot Be Recertified","11. Recording Certifications","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":"fl-hospice","state":"Florida","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}}