Election of Hospice, Election Statement Addendum and Notice of Election
Sets how a patient or representative elects hospice care with the Agency: what the election statement must contain, the effective date, the benefits the patient waives, the election statement addendum ("Patient Notification of Hospice Non-Covered Items, Services, and Drugs") that every patient electing on or after October 1, 2026 receives within the first 5 days and whenever it changes, election periods, the Notice of Election, re-election, and the DC Medicaid election rules.
About this policy
- Policy number
- DC-HSP-ELC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.24
- Library
- Washington, DC hospice · 60 policies
- Category
- Hospice care
- Sections
- 23
In short
- Hospice starts only after the patient or representative signs a complete election statement.
- The effective date can never be earlier than the date the statement is signed.
- For elections on or after October 1, 2026, give every patient the addendum listing what we will not cover, within the first 5 days.
- When a plan of care change affects the addendum, give the patient an update within 3 days.
- Give the signed election statement to billing the same day; the Notice of Election is due within 5 calendar days.
What's inside
23 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(a))
- 5. Who Signs
- 6. What the Election Statement Contains
- 7. Effective Date and Waived Benefits
- 8. The Election Statement Addendum
- 8.1 Deciding What Is Unrelated
- 8.2 Content of the Addendum
- 8.3 Timing, Signature and Filing
- 8.4 Updating the Addendum
- 9. Election Periods and Continuation
- 10. Notice of Election
- 11. Re-election
- 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 election statement for this patient. Where does the patient acknowledge choosing the attending physician?
- Show me the election statement addendum and the date you furnished it. Was it within the first 5 days of the effective date?
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