Election of the Hospice Benefit, Election Statement Addendum and Notice of Election
Sets out how a Medicare patient (or representative) elects the hospice benefit: the eight required parts of the election statement, the election statement addendum "Patient Notification of Hospice Non-Covered Items, Services, and Drugs" required for elections beginning on or after October 1, 2026, and its 5-day and 3-day time frames, the Notice of Election filed within 5 calendar days, election periods, the waiver of other Medicare benefits and re-election.
About this policy
- Policy number
- GA-HSP-ELC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.24
- Library
- Georgia hospice · 60 policies
- Category
- Hospice care
- Sections
- 19
In short
- Every Medicare patient signs a complete election statement (Form GA-HSP-ELC-01-A). The effective date is never before the signing date.
- For elections from October 1, 2026, give the addendum "Patient Notification of Hospice Non-Covered Items, Services, and Drugs" within 5 days of the effective date.
- If the plan of care changes what we cover, update the addendum and give it to the patient within 3 days.
- Signing the addendum only shows it was received. If the patient will not sign, write the reason on it.
- Tell billing the same day so the Notice of Election is filed within 5 calendar days.
What's inside
19 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. 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 and Updates
- 8. Notice of Election
- 9. Election Periods, Waiver and Re-election
- 10. Georgia Medicaid and Other Payers
- 11. Responsibilities
- 12. Records and Compliance Monitoring
- 13. Staff Training
- 14. References
- 15. Related Policies and Forms
- 16. Approval
- 17. Revision History
An inspector may ask
- Show me this patient’s election statement. Where are the attending physician choice, the palliative care acknowledgment, the waiver, the effective date, the cost-sharing and the BFCC-QIO information?
- This patient elected hospice after October 1, 2026. Show me the addendum, the date you gave it, and the signature or the reason it was not signed.
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