N.H. Admin. Code § He-W 544.17

Current through Register No. 50, December 12, 2024

Section He-W 544.17 - Payment for Licensed Practitioners' Services

(a) If a recipient's attending licensed practitioner, who is not an employee of the designated hospice or providing services under arrangement with the designated hospice, provides licensed practitioner services related or unrelated to the treatment of the terminal illness:

(1) These licensed practitioner services shall not be considered as part of the per diem rate described in He-W 544.14; and

(2) The licensed practitioner shall bill for these licensed practitioner services separately and be reimbursed at the regular licensed practitioner services rate in accordance with He-W 531.

(b) If a recipient does not have an attending licensed practitioner at the time of electing the hospice benefit, the medical director of the designated hospice provider or the licensed practitioner member of the hospice interdisciplinary group shall:

(1) Be the recipient's attending licensed practitioner; and

(2) Bill and receive payment as follows:

a. Licensed practitioner services that are related to the treatment of the terminal illness shall be considered hospice services and be included in the per diem rate described in He-W 544.14; and

b. Licensed practitioner services that are unrelated to treatment of the terminal illness shall be considered licensed practitioner services and shall be billed separately by the licensed practitioner and be reimbursed at the regular licensed practitioner services rate in accordance with He-W 531. These services shall not be billed by the hospice provider.

(c) If a recipient's attending licensed practitioner, who is not an employee of the designated hospice or providing services under arrangement with the designated hospice, requests through an order that the medical director or hospice licensed practitioner provide licensed practitioner services not described in He-W 544.10 these licensed practitioner services shall be billed as in (a)(1) and (a)(2) above.

N.H. Admin. Code § He-W 544.17

#9726-B, eff 7-1-10; amd by #9867-B, eff 2-11-11

Amended by Number 6, Filed February 8, 2024, Proposed by #13847, Effective 1/6/2024, Expires 1/6/2034 (formerly He-W 544.16) (See Revision Note at part heading for He-W 544).