{"ref":"LA-HH-PR-03","title":"Consent for Treatment, Freedom of Choice, and Disclosure of Charges","category":"Client rights","summary":"Sets out how the Agency obtains a signed consent for treatment and, when applicable, a signed release of information from every patient; how it protects the patient's right to choose an authorized healthcare provider and a home health agency without interference and obtains a signed freedom of choice statement; and how it tells each patient, orally and in writing and before care begins, what Medicare, Medicaid or other programs are expected to pay and what the patient may have to pay, with advance written notice of possibly non-covered care and of any reduction or end of care, including the Medicare notices CMS requires if the Agency is Medicare-certified.","inShort":["Explain the services first, then get the signed consent for treatment before giving care.","Have the patient sign the freedom of choice statement; never pressure a patient to choose us or any provider.","Before care starts, explain in writing what Medicare, Medicaid or insurance should pay and what the patient may owe.","Respect a refusal: explain the risks, write it down and tell the clinical manager and provider the same day.","Tell billing at once if coverage changes, so the patient gets written notice before the next visit."],"primaryCitation":"LAC 48:I §9129.A.5","citations":["LAC 48:I §9129.A.5","LAC 48:I §9129.A.6","LAC 48:I §9123.B","LAC 48:I §9123.B.3.l","LAC 48:I §9125.A.4","LAC 48:I §9125.A.7","LAC 48:I §9125.A.8","LAC 48:I §9115.B.3.a"],"federalCitations":["42 CFR §484.50(c)(4)","42 CFR §484.50(c)(7)","42 CFR §484.50(c)(8)","42 CFR §405.1200","42 CFR §405.1202","42 CFR §411.408","45 CFR §164.508"],"surveyorAsks":["Show me the signed consent for treatment and the freedom of choice statement in this record.","How did you tell this patient what Medicare or Medicaid would pay and what the patient would owe? Was it in writing and before care started?"],"forms":[{"ref":"LA-HH-PR-03-A","title":"Consent for Treatment and Release of Information"},{"ref":"LA-HH-PR-03-B","title":"Freedom of Choice Statement"},{"ref":"LA-HH-PR-03-C","title":"Notice of Payment Sources and Charges"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (LAC 48:I §9129.A.5)","5. Consent for Treatment","6. Release of Information","7. Freedom of Choice","8. Verification of Coverage and Written Disclosure of Charges","9. Advance Written Notice of Non-Covered Care, Reductions and Terminations","10. Responsibilities","11. Records and Compliance Monitoring","12. Staff Training","13. References","14. Related Policies and Forms","15. Approval","16. Revision History"],"version":"1.0","sample":false,"pack":"la-hha","state":"Louisiana","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}