Local Coverage Determination (LCD) for Hospice - Determining Terminal Status
Medicare contracts with National Government Services to review claims to determine eligibility of Medicare beneficiaries for hospice benefits.  This LCD outlines the guidelines used by NGS in making that determination. They are intended to be used to identify any Medicare beneficiary whose current condition is likely to result in a life expectancy of six months or less.

Massachusetts Hospice Care Fact Sheet

FY 2010 Final Hospice Wage Index

Medicare Conditions of Participation for Hospice Care
Crosswalk between Medicare Hospice CoPs and DPH State Hospice Licensure Regulations (Adobe Acrobat is required to download the brochure)

Massachusetts Licensure of Hospice Programs Regulations (105CMR 141.000), Massachusetts Department of Public Health. Effective, 10/10/03.
(Available at www.mass.gov/Eeohhs2/docs/dph/regs/105cmr141.pdf)

MassHealth Hospice Regulations. Commonwealth of MA. 130 CMR 437.000. Provider Manual Series. Hospice Manual. 8/1/98.
Available at www.mass.gov/masshealth On home page, scroll down and click on MassHealth Regulations and other Publications. Click on MassHealth Regulations. Next page, click on MassHealth Provider Regulations. Then scroll down to Hospice.)

MassHealth Hospice Rates. Massachusetts Division of Health Care Finance and Policy.
(Available at www.state.ma.us/dhcfp.)
- Click on "regulations".
- Click on regulations again.
- Click on hospice services.

Medicare and Medicaid Hospice Conditions of Participation, Final Rule, June 5, 2008
http://edocket.access.gpo.gov/2008/pdf/08-1305.pdf

State Operations Manual Appendix M - Guidance to Surveyors: Hospice (Rev.)
http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09-19.pdf

Medicare Hospice Manual. Available for purchase through the Government Printing Office/Superintendent of Documents by calling 202-512-1800 or through National Technical Information Service by calling 888-584-8332.
Also available on-line at www.cms.hhs.gov/Manuals/PBM/list.asp. Choose Paper Based Manuals from the menu on the left hand side.

Medicare Customer Service. Website: www.ahsmedicare.com.

All Inquiries 866-539-5593 (effective June 1, 2005)
-Status of claim
-Remittance request
-Denial definition
-Passwords
-Beneficiary eligibility
-Systems problems
-Suspended claim resolution
-Web-site navigation
-Coverage questions
-Adjustments
-Billing Procedures
-Medimessage interpretation
-Interpretation of Conditions of Participation

D. Rigney Cunningham
Executive Director
Hospice & Palliative Care Federation of MA
1420 Providence Highway, Suite 277
Norwood, MA 02062
Tel. 781-255-7077
Fax 781-255-7078
EMail: hospicefed@aol.com
Web site: www.hospicefed.org