{"ref":"MI-HSP-FIN-01","title":"Billing, Medicaid and Medicare Admission Records, and Care Regardless of Ability to Pay","category":"Business","summary":"Sets out how the Agency verifies coverage, completes Medicaid admissions and discharges in CHAMPS, files Medicare notices of election and termination on time, bills accurately for the level of care actually provided, handles Medicaid nursing facility room and board and the patient-pay amount (with a receipt every time), never bills a Medicaid beneficiary for coinsurance or room and board, and never stops or reduces care because a patient cannot pay.","inShort":["No patient's hospice care is stopped or reduced because they cannot pay.","Check coverage before the first visit. Medicaid Health Plan patients need the plan's approval first.","Medicaid admissions and discharges are done in CHAMPS, and the patient or representative signs the printout.","Never bill a Medicaid patient or family for coinsurance or nursing home room and board.","Give a receipt every time the Agency collects a patient-pay amount."],"primaryCitation":"42 CFR §418.100(d)","citations":["Michigan Medicaid Provider Manual, Hospice, Sections 1, 3, 4 and 7","MCL 333.20201(2)(a)","MCL 333.20202(7)","Mich. Admin. Code R 325.45127","MCL 400.607"],"federalCitations":["42 CFR §418.100(d)","42 CFR §418.24(e)","42 CFR §418.26(e)","42 CFR §418.28(d)","42 CFR §418.302","42 CFR §418.309"],"surveyorAsks":["Have you ever discharged or reduced care for a patient because of inability to pay?","Show me the signed CHAMPS admission printout for this Medicaid patient."],"forms":[{"ref":"MI-HSP-FIN-01-A","title":"Patient-Pay Amount Receipt"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.100(d))","5. Before Admission: Coverage","6. Medicaid Admission and Discharge in CHAMPS","7. Medicare Notices","8. Levels of Care and Claims","9. Nursing Facility Room and Board and the Patient-Pay Amount","10. Care Regardless of Ability to Pay","11. Financial Documents for the Department","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":"mi-hospice","state":"Michigan","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}}