Election of Hospice, Election Statement Addendum and Notice of Election
Sets out how a patient (or representative) elects hospice care with the Agency: the required content of the election statement, how the election is explained and completed, the election statement addendum that the Agency must give in writing for every election beginning on or after October 1, 2026 (within the first 5 days of the effective date) and update within 3 days when the plan of care changes the determinations, the notice of election filed within 5 calendar days, election periods, the waiver of other Medicare benefits, re-election, and the Michigan Medicaid and dual-eligible rules.
- Policy number
- MI-HSP-ELC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.24
- Library
- Michigan hospice · 59 policies
- Category
- Hospice care
- Sections
- 19
In short
- Explain the election in plain words: hospice is comfort care, the patient gives up other Medicare care for the terminal illness, and may stop hospice at any time.
- Check every item on Form ELC-01-A, including the attending physician the patient chose and the effective date. The date can never be before the signature.
- Give the non-covered items addendum (Form ELC-01-B) in writing at the admission visit, and never later than day 5.
- When the plan of care changes what is covered, update the addendum and give it to the patient within 3 days.
- Tell billing the effective date the same day. The notice of election must be 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, Duration, Waiver and Re-election
- 10. Michigan Medicaid and Dual-Eligible Patients
- 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. Does it contain every element 42 CFR §418.24(b) requires?
- When did this patient receive the election statement addendum? Was it within 5 days of the effective date of election?
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