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Medical Assistance Programs - Hospice

Revised October 21, 2008

Purpose: To provide an overview of the Hospice program and explain how to correctly determine eligibility for Hospice.

Hospice Clarifying Information Overview and general eligibility Who should I contact HCS or the CSO?  When to use Hospice as a service?  (Already eligible for a non institutional medical program) When to use Hospice as a program? (Using the C01 Medical Coverage group (institutional rules) for eligibility). What is a Hospice election notice?  How will my DSHS agency know I have elected Hospice?

WORKER RESPONSIBILITIES Hospice Applications when a client is already eligible for CNP (non institutional CNP) Hospice Applications using institutional rules (C01 medical coverage group).  This section includes detailed ACES instructions.  Change of Circumstances Hospice and ADSA Waivers Hospice Special Circumstances

Hospice Agency Contacts Hospice Agencies FAX Medicaid Hospice notification form  to the HRSA DMS HUB at:  360-725-1965 Hospice Agency Contacts - Address, phone numbers and provider numbers.  This link lists the Hospice Care Centers.  Hospice Care Centers are considered medical institutions.

For further assistance, contact your medical regional representative: Region 1 Mary Beth Ingram 360-725-1327 ingramb@dshs.wa.gov Region 2 Kathy Johansen 360-725-1321 johankj@dshs.wa.gov Region 3 Kevin Cornell 360-725-1423 corneke@dshs.wa.gov Region 4 Karin Kramer 360-725-2075 krameke@dshs.wa.gov Region 5 Cindy Palko 360-725-1324 palkocm@dshs.wa.gov Region 6 Cathy Fisher 360-725-1357 fishecl@dshs.wa.gov

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Modification Date: October 21, 2008

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