Election of Hospice, Election Statement Addendum and Notice of Election
Explains how a Medicare or Medicaid patient elects hospice care with the Agency: the content of the election statement (42 CFR §418.24(b)); the mandatory election statement addendum titled "Patient Notification of Hospice Non-Covered Items, Services, and Drugs" for every election beginning on or after October 1, 2026, given within the first 5 days of the effective date and updated within 3 days of plan of care changes (§418.24(c)-(d)); filing the Notice of Election within 5 calendar days (§418.24(e)); benefit periods; and how the election relates to Florida admission consent.
- Policy number
- FL-HSP-ELC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.24
- Library
- Florida hospice · 60 policies
- Category
- Hospice care
- Sections
- 20
In short
- Complete the election statement (Form FL-HSP-ELC-01-A) with the patient’s chosen attending physician and an effective date no earlier than the signature.
- Every election from October 1, 2026 needs the addendum (Form FL-HSP-ELC-01-B), in writing, within the first 5 days. Write "None" if nothing is unrelated.
- When a plan of care change affects what we do not cover, update the addendum within 3 days and give the update in writing.
- If the patient will not sign the addendum, write the reason on it.
- Give the effective date to billing the same day. The Notice of Election is due within 5 calendar days.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.24)
- 5. Benefit Periods
- 6. The Election Statement
- 7. Completing the Election
- 8. The Election Statement Addendum
- 8.1 Giving and updating the addendum
- 9. Notice of Election
- 10. Waiver of Other Benefits and Re-election
- 11. Patients Who Do Not Use Medicare or Medicaid
- 12. Responsibilities
- 13. Records and Compliance Monitoring
- 14. Staff Training
- 15. References
- 16. Related Policies and Forms
- 17. Approval
- 18. Revision History
An inspector may ask
- Show me this patient’s election statement. Does it name the attending physician, with the patient’s acknowledgment that this was their choice?
- Show me the addendum. When was it given, compared with the effective date of the election?
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