Certification and Recertification of Terminal Illness and Face-to-Face Encounters
Sets how the Agency obtains a timely, complete written certification of terminal illness for every benefit period, who may certify, what the certification and narrative must say, how face-to-face encounters are made before the third and later periods (in person while the District is under the hospice enrollment moratorium), and the extra DC Medicaid signature and timing rules.
About this policy
- Policy number
- DC-HSP-ELC-02
- Version
- 1.0
- Main rule
- 42 CFR §418.22
- Library
- Washington, DC hospice · 60 policies
- Category
- Hospice care
- Sections
- 20
In short
- Every benefit period needs a written physician certification that the patient is terminally ill.
- A certification can be signed no more than 15 calendar days before the period starts.
- The physician writes a narrative about this patient, immediately above the signature, with no check boxes.
- Before the third period and every later one, a hospice physician or nurse practitioner sees the patient within the 30 days before recertification.
- While the District is under the hospice enrollment moratorium, face-to-face encounters are made in person.
What's inside
20 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 §418.22(a)(1))
- 5. When the Certification Is Obtained
- 6. Who Certifies
- 7. What the Physician Considers
- 8. What the Certification Says
- 9. Oral Certification
- 10. Face-to-Face Encounters
- 10.1 Telehealth Encounters and the Moratorium
- 11. Tracking Recertifications
- 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 each benefit period of this patient. Were they signed within the time allowed?
- Who signed the initial certification? Was the attending physician’s certification obtained?
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