Md. Code Regs. 10.67.06.23

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.67.06.23 - Benefits - Hospice Care Services

A. An MCO shall include in its benefits package medically necessary hospice care services to enrollees who are terminally ill.

B. The Department shall allow an enrollee to disenroll from an MCO and choose a new MCO if:

(1) The enrollee was auto-assigned to the MCO; and

(2) The enrollee's hospice provider does not contract with the enrollee's assigned MCO.

C. If an enrollee who is in a hospice that does not contract with the enrollee's MCO and the enrollee will not voluntarily choose a new MCO, the enrollee's current MCO:

(1) Shall authorize and pay the out-of-network hospice provider at the established Medicaid rate, to ensure continuity of care; and

(2) May not require the hospice care enrollee to change their out-of-network hospice provider to an in-network hospice provider.

Md. Code Regs. 10.67.06.23

Regulations .23 recodified from 10.09.67.23 effective 46:22 Md. R. 976, eff. 11/1/2019