Medicare Managed Care Manual (Pub. 100-16), Ch. 18a § 70.2
Hospice Care Costs
70.2 - Hospice Care Costs
(Rev. 30, 09-05-03)
If a Medicare enrollee of an HCPP makes an election to receive hospice care services
under §1812(d) of the Act, payment for these hospice care services is made to the
Medicare participating hospice that furnishes the services, in accordance with
42 CFR Part 418 and the Hospice Manual. While the HCPP enrollee's hospice election is
in effect, the HCPP may only be paid for the following covered Medicare services
furnished to such enrollee:
• Services of the enrollee's attending physician, if the physician is an employee or
contractor of the HCPP and is not employed by or under contract to the enrollee's
hospice; and
• Services not related to the treatment of the terminal condition for which hospice
care was elected or a condition related to the terminal condition.
A Medicare beneficiary's hospice election may continue as long as the individual
continues to desire to receive hospice services while terminally ill. Upon revocation of
the election, the individual resumes normal Medicare coverage and any services provided
by the HCPP will be reimbursed in the usual manner.