Election of the Hospice Benefit and Notice of Election
Explains who may elect hospice, what the election statement must contain under Texas and Medicare rules, how the effective date is set, how and when the Agency gives the new election statement addendum "Patient Notification of Hospice Non-Covered Items, Services, and Drugs" for elections from October 1, 2026, how it is updated, and how the Notice of Election is filed on time.
About this policy
- Policy number
- TX-HSP-ELC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.24
- Library
- Texas hospice · 59 policies
- Category
- Hospice care
- Sections
- 25
In short
- Only the patient, or a legal representative if the patient cannot decide, signs the election statement. Never sign it for them.
- The start date can never be earlier than the day they sign.
- Explain that hospice care is for comfort, not cure, and that the patient should call us first for anything related to the terminal illness.
- For elections from October 1, 2026, give the "Patient Notification of Hospice Non-Covered Items, Services, and Drugs" within 5 days of the start date.
- If the plan of care changes what is or is not covered, update that notice within 3 days and give the patient a copy.
- Send the signed election to the office the same day so the Notice of Election is filed within 5 calendar days.
What's inside
25 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; 26 TAC §558.801(g))
- 5. Who May Elect
- 6. Contents of the Election Statement
- 7. Completing the Election
- 8. What the Election Waives
- 9. The Election Statement Addendum (Elections on or After October 1, 2026)
- 9.1 Contents
- 9.2 Who decides what is unrelated
- 9.3 When it is given
- 9.4 Updates
- 9.5 If the patient dies, revokes or is discharged first
- 10. Notice of Election
- 11. Duration of the Election and Re-Election
- 12. Texas Medicaid Elections
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me the election statement for this patient. Does it contain every element Medicare and Texas require?
- This election began after October 1, 2026. Where is the election statement addendum, when was it furnished, and is it signed?
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