Sec. 10.09.35.04. Duration of Hospice Care

A. An individual may elect to receive hospice care during one or more of the following election periods:

(1) An initial 90-day period;

(2) A subsequent 90-day period; or

(3) An unlimited number of subsequent 60-day periods.

B. The periods of care indicated in §A of this regulation are available in the order listed and may be elected separately at different times.

C. An election period or an extended election period shall terminate before expiration when one of the following conditions is met:

(1) The participant dies;

(2) The election of hospice care is revoked in accordance with Regulation .05D of this chapter;

(3) The participant's eligibility for Medical Assistance is cancelled;

(4) The Program determines that the election period or extended election period shall be terminated for cause. Cause for termination may include, but shall not be limited to:

(a) A change in the participant's prognosis as being terminally ill;

(b) Relocation by the participant to a place of residence where a hospice care provider is not available; or

(c) Action or behavior of the participant that makes continuation of hospice care inappropriate, such as misconduct, fraud, or repeated instances of willfully and knowingly seeking services related to the terminal illness from other than the designated provider.

D. When a participant revokes the election of hospice care, in accordance with Regulation .05D of this chapter, during an election period, any remaining days in that election period shall be forfeited. Thereafter, the participant may elect hospice coverage for any remaining election periods for which the participant is eligible.

E. When a participant revokes the election of hospice care during an extended election period, further Program coverage of hospice care shall be forfeited.

F. The waiver of rights to Program payments described in Regulation .05B(5) of this chapter shall expire as of the effective date of termination of the election period or extended election period.