Certification and Recertification of Terminal Illness and Face-to-Face Encounters
Sets out who signs the certification of terminal illness in Louisiana (never an APRN), the Medicare and Louisiana Medicaid time frames for initial and later certifications, the narrative and attestation content, the face-to-face encounter before the third and later periods, the 2026 telehealth limits during the nationwide enrollment moratorium, and what happens when a physician will not recertify.
About this policy
- Policy number
- LA-HSP-ELC-02
- Version
- 1.0
- Main rule
- LAC 48:I §8219.B.2
- Library
- Louisiana hospice · 60 policies
- Category
- Hospice care
- Sections
- 19
In short
- Every election period needs a certification of terminal illness signed by the right physicians.
- An APRN or nurse practitioner never signs a certification in Louisiana.
- Start recertification at least 21 days before the period ends.
- Before the third and every later period, a hospice physician or nurse practitioner does a face-to-face visit within 30 days before the recertification.
- Write down any verbal certification in the record as soon as you receive it.
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 (LAC 48:I §8219.B.2)
- 5. Who Signs
- 6. Timing
- 7. Content of the Certification
- 8. Oral and Verbal Certification
- 9. Face-to-Face Encounters
- 10. When the Physician Will Not Recertify
- 11. Louisiana Medicaid Documentation
- 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 the certification for this patient’s current period. Who signed it, and when?
- This patient’s attending is a nurse practitioner. Who certified the terminal illness?
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