(1) The medicaid agency's hospice program is a 24 hour a day program that allows a terminally ill client to choose physical, pastoral/spiritual, and psychosocial comfort care and a focus on quality of life. A hospice interdisciplinary team communicates with the client's nonhospice care providers to ensure the client's needs are met through the hospice plan of care. Hospitalization is used only for acute symptom management.
(2) A client, a physician, or an authorized health care representative may initiate hospice care.
(3) Hospice care is provided in a client's temporary or permanent place of residence.
(4) Hospice care ends when:
(a) The client or an authorized health care representative revokes the hospice care;
(b) The hospice agency discharges the client;
(c) The client's physician determines hospice care is no longer appropriate; or
(d) The client dies.
(5) Hospice care includes the provision of emotional and spiritual comfort and bereavement support to the client's family member(s).
(6) Medicaid agency-approved hospice agencies must meet the general requirements in chapter 182-502 WAC, Administration of medical programs—Providers.
(7) A client enrolled in a medicaid agency-contracted managed care organization (MCO) must receive all hospice services, including facility room and board, directly through that MCO.
(8) The MCO is responsible for arranging and providing all hospice services for an MCO client consistent with the rules in this chapter.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 25-16-015, s 182-551-1000, filed 7/25/25, effective 9/1/25. Statutory Authority: RCW 41.05.021, Section 2302 of the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148), and Section 1814 (a)(7) of the Social Security Act. WSR 12-09-079, § 182-551-1000, filed 4/17/12, effective 5/18/12. WSR 11-14-075, recodified as § 182-551-1000, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-18-033, § 388-551-1000, filed 8/30/05, effective 10/1/05. Statutory Authority: RCW 74.09.520, 74.08.090, 42 C.F.R. 418.22 and 418.24. WSR 99-09-007, § 388-551-1000, filed 4/9/99, effective 5/10/99.]