Section 17b-262-839 - Coordination of hospice and waiver services(a) For clients who receive waiver services prior to electing the hospice benefit under Medicaid, waiver services shall continue to be available.(b) It is the responsibility of hospice to develop a plan of care that coordinates the hospice and waiver services. It is the responsibility of the hospice to initiate coordination with the waiver program case manager so that the client receives all of the care and services necessary. The waiver program's case manger is responsible for adjusting the waiver services so there is no duplication of services provider by the hospice or the waiver. These objectives should be accomplished according to the following principles:(1) The best interest of the client is the key consideration. In circumstances when the hospice and waiver program case managers cannot agree on what is best for the client they shall ask the department for assistance in this determination.(2) Each program shall provide services consistent with the goals of their respective programs. The goal of hospice care is to keep the client as comfortable as possible while maintaining his or her dignity and quality of life; the goal of the waiver program is to keep clients out of institutions.(3) Services related to the terminal diagnosis are the responsibility of the hospice.(4) Services provided prior to the date of terminal diagnosis are generally considered to be unrelated to the terminal diagnosis.(5) Services unrelated to the terminal diagnosis may be billed in addition to the hospice reimbursement by the provider rendering the service.(6) For the purpose of developing a plan of care, the presumption is that waiver services provided prior to the date of the terminal diagnosis should continue to be provided as waiver services. It is presumed that services initiated after the date of the terminal diagnosis are the responsibility of the hospice although this is subject to review and reconsideration by the hospice as approved by the department.Conn. Agencies Regs. § 17b-262-839
Adopted effective July 7, 2009