Certification of Terminal Illness: 48-Hour Oral Certification, Written Certification and Recertification
Sets out how the Agency obtains certification of terminal illness: the Ohio requirement for an oral statement prior to or within 48 hours after admission and written confirmation after admission, the Medicare written and oral certification time frames, who may certify, the content and narrative, face-to-face encounters before the third benefit period, recertification, and the Ohio Medicaid portal entries.
About this policy
- Policy number
- OH-HSP-ELC-02
- Version
- 1.0
- Main rule
- OAC 3701-19-20(G)
- Library
- Ohio hospice · 60 policies
- Category
- Hospice care
- Sections
- 18
In short
- Ohio rule: get spoken certification from the attending physician (if any) and an Agency physician before admission or within 48 hours after it.
- Record every spoken certification right away on the certification form, with the date, time and physician.
- The signed written certification, with the physician's own narrative, must be on file before any claim.
- Nurse practitioners and physician assistants may be attending physicians but may not certify terminal illness.
- Patients reaching the third benefit period need a face-to-face visit no more than 30 days before it.
What's inside
18 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (OAC 3701-19-20(G); 42 CFR §418.22)
- 5. Two Clocks: Ohio 48 Hours and Medicare 2 Calendar Days
- 6. Who Certifies
- 7. Content of the Certification
- 8. Face-to-Face Encounters (Medicare)
- 9. Recording and Filing
- 10. Recertification and When the Physician Will Not Recertify
- 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
- For this patient, when did you obtain the oral statements certifying terminal illness, and from whom?
- Show me the written certification signed by the attending physician (if any) and the medical director or IDT physician.
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