(1) An individual eligible for hospice care or his representative must file an election statement with a particular hospice in order to receive that care. The department will follow Medicare guidelines in administering this provision.

(2) The department adopts and incorporates by reference the following sections of 42 CFR as amended November 22, 2005:

(a) 418.21 which sets forth the duration of hospice care coverage and election periods; and

(b) 418.25 which sets forth the requirements for admission to hospice.

(3) The department adopts and incorporates by reference the following section of 42 CFR as amended June 5, 2008:

(a) 418.20 which sets forth eligibility requirements.

(4) The department adopts and incorporates by reference the following sections of 42 CFR as amended August 22, 2014:

(a) 418.24(a) through 418.24(f) which sets forth the requirements for individual election of hospice care; and

(b) 418.26 which sets forth the requirements for discharge from hospice care.

(5) A copy of the sections of CFR listed in (2) through (4) may be obtained from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59320-2951.

(6) An individual waives all rights to Medicaid payments for the duration of the election of hospice care for the following services:

(a) Hospice care provided by a hospice other than the hospice designated by the individual (unless provided under arrangements made by the designated hospice).

(b) Any Medicaid services that are related to the treatment of the terminal condition for which hospice care was elected or a related condition or that are equivalent to hospice care except for:

(i) services provided by the designated hospice;

(ii) services provided by another hospice under arrangements made by the designated hospice; and

(iii) services provided by the individual's attending physician if that physician is not an employee of the designated hospice or receiving compensation from the hospice for those services.

(7) The hospice chosen by the eligible individual, or their representative, must file a Notice of Election (NOE) with the department within five calendar days after the effective date of the election statement. NOEs must be sent to the Senior & Long Term Care Division, 111 N. Sanders, P.O. Box 4210, Helena, MT 59604-4210. The department may waive the consequences of failure to submit a timely-filed NOE. A hospice must fully document and furnish any requested documentation to the department for a determination of exception.

(8) When the hospice election is ended due to discharge, the hospice must file a Notice of Termination of Election with the department within five calendar days after the effective date of the discharge, unless it has already filed a final claim for that beneficiary. Notice of Terminations must be sent to the Senior & Long Term Care Division, 111 N. Sanders, P.O. Box 4210, Helena, MT 59604-4210.