Hi, Joelle.
In the Medicare Benefit Policy Manual, Chapter 9, Section 40.1.9, CMS discusses hospice coverage of "Other Items and Services". The manual states, "The hospice is responsible for providing any and all services indicated in the plan of care as reasonable and necessary for the palliation and management of the terminal illness and related conditions." This section goes on to discuss coverage of ambulance services and the distinction between coverage for initial transport on the day hospice care begins (prior to the initial assessment) and transport during the course of care. The manual indicates that ambulance transport of a hospice patient, which are related to the terminal illness and which occur after the effective date of election, are the responsibility of the hospice.
While this section does not specifically discuss non-emergent transport, our sense is that if a patient is in need of respite care (which is considered reasonable and necessary under the circumstances and is included on the plan of care) and non-emergent transport is needed to safely move the patient from home to a facility, that non-emergent transport would be considered reasonable and necessary and related to the terminal illness and related conditions and fall under the responsibility of the hospice to cover.
I hope this helps. Take care,
Theresa
Theresa M. Forster
VP for Hospice Policy & Programs
National Association for Home Care & Hospice
Office: 202-547-7424
Direct: (202) 355-1661
tmf@nahc.org
Original Message:
Sent: 6/29/2022 9:12:00 AM
From: Joelle Goldade
Subject: Hospice liability for respite transfer
Theresa and group,
Where would I find regulatory guidance relative to hospice agency liability for non emergent transfer costs to move a client into a facility for a respite stay? Thank you ahead of time!
Joelle Goldade RN, BSN, PHN, COS-C, HCS-D
Clinical Coordinator Lead (DCS)
CHI Health at Home – Home Health and Hospice
4265 45th Street South Suite 200
Fargo ND 58104
Work/Mobile Number: 701.640.6209
joelle.goldade@commonspirit.org
http://CHIHealthatHome.info
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