{"ref":"LA-HSP-ELC-01","title":"Election of Hospice, Election Statement Addendum and Notice of Election","category":"Hospice care","summary":"Sets out the content and signing of the hospice election statement and attending practitioner designation, the election statement addendum that is mandatory for elections on or after October 1, 2026 (within the first 5 days, updates within 3 days), the Medicare Notice of Election within 5 calendar days, and the Louisiana Medicaid NOE, CTI and prior authorization steps.","inShort":["No hospice services before the patient or representative signs the election statement.","The patient chooses the attending practitioner and writes the effective date, which can never be before the signing date.","For elections on or after October 1, 2026, give the non-covered items addendum within the first 5 days, and update it within 3 days of a plan of care change.","Verbal elections are never accepted.","Billing files the Medicare NOE within 5 calendar days and sends the Medicaid NOE and CTI within 10 calendar days."],"primaryCitation":"LAC 48:I §8219.A","citations":["LAC 48:I §8219.A","LAC 48:I §8219.C.2.e","LAC 48:I §8217.I.2","LAC 48:I §8233.H.6","Louisiana Medicaid Services Manual, Chapter 24 (Hospice), §§24.1, 24.2, 24.5, 24.6"],"federalCitations":["42 CFR §418.24","42 CFR §418.21","42 CFR §418.400","42 CFR §418.104(a)(2)"],"surveyorAsks":["Show me this patient’s election statement. Who chose the attending physician?","This patient elected hospice after October 1, 2026. Where is the addendum, and when was it given?"],"forms":[{"ref":"LA-HSP-ELC-01-A","title":"Hospice Election Statement and Designation of Attending Practitioner"},{"ref":"LA-HSP-ELC-01-B","title":"Patient Notification of Hospice Non-Covered Items, Services, and Drugs"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (LAC 48:I §8219.A)","5. Content of the Election Statement","6. Completing the Election","7. Election Statement Addendum (Elections On or After October 1, 2026)","7.1 Addendum Time Frames, Updates and Refusals","8. Notice of Election (Medicare)","9. Louisiana Medicaid Beneficiaries","10. Election Periods, Waiver of Other Benefits and Re-election","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"la-hospice","state":"Louisiana","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}}