Hospice of Montgomery
1111 Holloway Park
Montgomery, AL 36117
(334) 279-6677
Medical Professionals
Hospice of Montgomery Eligibility
When curative treatment is no longer effective or appropriate, Hospice of Montgomery focuses on providing the best quality of life possible.
You can continue as the patient’s primary physician, or your patient can be closely followed by our Medical Director, and you will be updated you on your patient’s progress throughout the hospice experience. When making a referral, be sure to mention Hospice of Montgomery by name.
You can continue as the patient’s primary physician, or your patient can be closely followed by our Medical Director, and you will be updated you on your patient’s progress throughout the hospice experience. When making a referral, be sure to mention Hospice of Montgomery by name.
Coverage of hospice care depends upon a physician’s certification that a patient’s life expectancy is six months or less if the illness runs its normal course. Recognizing that determination of life expectancy during the course of a terminal illness is difficult, the Center for Medicare and Medicaid Services (CMS) has published medical criteria, which addresses several of the concerns that many physicians have had regarding the Hospice Medicare Benefit. This memorandum states in part:
“…physicians and other health care practitioners can be encouraged that the Medicare program includes a hospice benefit that provides coverage for a variety of services and products designed for those with terminal diagnoses. When properly certified and appropriately managed, hospice care is a supportive and valuable covered treatment option… Hospice is not about death, but rather about the quality of life as it nears its end, for all concerned the patient, family and friends, and for the health professional community.
Physicians and health care providers in the community, skilled nursing facilities, and hospitals are urged to raise awareness among their patients about the hospice benefit and its availability. Further, a beneficiary may independently elect hospice care. The beneficiary may discuss this option in the event that he or she has a terminal diagnosis; however, in all such cases, a physician must certify that the beneficiary has a terminal diagnosis with a six month prognosis, if the illness runs its usual course.
Hospice care that is covered by Medicare is chosen for specified amounts of time known as “election periods”. Essentially, a physician may certify a patient for hospice care coverage for two initial 90-day election periods, followed by an unlimited number of 60-day election periods. Each election period requires that the physician certify a terminal illness.
Generally speaking, the hospice benefit is intended primarily for use by patients whose prognosis is terminal, with six months or less of life expectancy. The Medicare program recognizes that terminal illnesses do not have entirely predictable courses; therefore, the benefit is available for extended periods of time beyond six months provided that proper certification is made at the start of each coverage period.
Recognizing that prognoses can be uncertain and may change, Medicare’s benefit is not limited in terms of time. Hospice care is available as long as the patient’s prognosis meets the law’s six month test.
This test is a general one. As the governing statute says: “The certification of terminal illness of an individual who elects hospice shall be based on the physician’s or medical director’s clinical judgment regarding the normal course of the individual’s illness.”
CMS recognizes that making medical prognostication of life expectancy is not always an exact science. Thus, physicians need not be concerned. There is no risk to a physician about certifying an individual for hospice care that he or she believes to be terminally ill.”
Physicians and health care providers in the community, skilled nursing facilities, and hospitals are urged to raise awareness among their patients about the hospice benefit and its availability. Further, a beneficiary may independently elect hospice care. The beneficiary may discuss this option in the event that he or she has a terminal diagnosis; however, in all such cases, a physician must certify that the beneficiary has a terminal diagnosis with a six month prognosis, if the illness runs its usual course.
Hospice care that is covered by Medicare is chosen for specified amounts of time known as “election periods”. Essentially, a physician may certify a patient for hospice care coverage for two initial 90-day election periods, followed by an unlimited number of 60-day election periods. Each election period requires that the physician certify a terminal illness.
Generally speaking, the hospice benefit is intended primarily for use by patients whose prognosis is terminal, with six months or less of life expectancy. The Medicare program recognizes that terminal illnesses do not have entirely predictable courses; therefore, the benefit is available for extended periods of time beyond six months provided that proper certification is made at the start of each coverage period.
Recognizing that prognoses can be uncertain and may change, Medicare’s benefit is not limited in terms of time. Hospice care is available as long as the patient’s prognosis meets the law’s six month test.
This test is a general one. As the governing statute says: “The certification of terminal illness of an individual who elects hospice shall be based on the physician’s or medical director’s clinical judgment regarding the normal course of the individual’s illness.”
CMS recognizes that making medical prognostication of life expectancy is not always an exact science. Thus, physicians need not be concerned. There is no risk to a physician about certifying an individual for hospice care that he or she believes to be terminally ill.”
