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The purpose of the hospice service is to provide for the palliation or management of a recipient’s terminal illness and related conditions. Under federal guidelines, the hospice benefit is available to individuals who have been certified by a physician to be terminally ill. An individual is considered to be terminally ill if he/she has a medical prognosis that his or her life expectancy is 6 months or less. Individuals who meet these requirements can elect the Medicaid hospice benefit.
The provision of hospice care is generally in the home to avoid an institutional setting and to improve the individual’s quality of life until he or she dies. However, individuals eligible for Medicaid may choose to reside in a nursing facility and receive hospice care in that setting.
In order to be covered, a plan of care must be established before services are provided. The following are covered hospice services: nursing care; medical social services; physicians’ services; counseling services; home health aide; medical appliances and supplies, including drugs and biologicals; and physical and occupational therapy. In general, the services must be related to the palliation or management of the recipient’s terminal illness, symptom control or to enable the individual to maintain activities of daily living and basic functional skills.
Additional services may be provided under the hospice benefit, subject to special coverage requirements. Continuous home care may be provided in a period of crisis. Short-term inpatient care is covered, as long as it is provided in a participating hospice unit or a participating hospital or nursing facility that meets hospice standards.
To obtain further information regarding the Maryland Medicaid Hospice Program, please call or write us at:
Division of Long Term Care Services
Maryland Medicaid Hospice Program
201 W. Preston Street, Room 119
Baltimore, MD 21201
(410) 767-6771 /1-877-4MD-DHMH / (410) 767-1714
Memo on Hospice Rates 2015
Memo on Enhanced Routine Home Care and Service Intensity Add-on Payment
Transmittal No. 11 - 2016 Rates
Transmittal No. 14 - 2017 Rates
201 W. Preston Street, Baltimore, MD 21201-2399
(410) 767-6500 or 1-877-463-3464
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