N.H. Admin. Code § He-W 544.02

Current through Register No. 50, December 12, 2024

Section He-W 544.02 - Recipient Eligibility Requirements

(a) To be eligible to receive hospice care, recipients age 21 and over shall:

(1) Be certified as terminally ill in accordance with He-W 544.06;

(2) Elect hospice care in accordance with He-W 544.04; and

(3) Upon election of hospice care pursuant to (2) above, agree to waive all rights to the following medicaid services:

a. Hospice care provided by a hospice other than the one designated by the recipient, unless provided under arrangements made by the designated hospice;

b. Medicaid services that are:

1. Related to the treatment of the terminal illness for which hospice care was elected;

2. Related to the treatment of a condition or complication related to the terminal illness for which hospice care was elected; or

3. Equivalent to, or duplicative of, hospice services; and

c. Medicaid home and community-based care waiver services that are equivalent to, or duplicative of, hospice services.

(b) To be eligible to receive hospice care, recipients under the age of 21:

(1) Shall be certified as terminally ill in accordance with He-W 544.06;

(2) Shall elect hospice care in accordance with He-W 544.04; and

(3) Shall not, in accordance with 42 U.S.C. 1395d(d)(2), be required to waive rights to medicaid services that are related to treatment of the recipient's condition for which a diagnosis of terminal illness has been made.

(c) A recipient shall not be required to waive rights to the following services, which shall be covered in addition to hospice services:

(1) Services provided by the recipient's medicaid licensed practitioner if that licensed practitioner is not an employee of the designated hospice or is not receiving compensation from the hospice for those services; and

(2) Room and board services provided by a residential care facility or a nursing facility if the recipient meets the facility's level of care.

N.H. Admin. Code § He-W 544.02

#9726-A, eff 7-1-10; ss by #9867-A, eff 2-11-11

Amended by Number 6, Filed February 8, 2024, Proposed by #13847, Effective 1/6/2024, Expires 1/6/2034 (See Revision Note at part heading for He-W 544).